Winge Kristian, Skau Anne-Marie, Stimpel Hans, Nielsen Kurt K, Werdelin Lene
Department of Neurology, H:S Bispebjerg Hospital, Copenhagen NV, Denmark.
Neurourol Urodyn. 2006;25(2):116-22. doi: 10.1002/nau.20193.
Prevalence of lower urinary tract symptoms (LUTS) in Parkinsons disease (PD) is reported as 27%-39% based on validated questionnaires which do not consider the degree of bother. To estimate the prevalence of LUTS in patients with PD, the severity of symptoms, the volume of postmicturitional urine, and to estimate differences compared to non-PD patients referred for urological evaluation.
One hundred seven patients with PD were evaluated using two sets of validated questionnaires (Dan-PSS and IPSS) about LUTS; postmicturitional residual urine was recorded, and compared to 61 patients without PD presenting at an urological clinic for examination.
Bothersome LUTS measured using Dan-PSS scores correlated significantly with Hoehn and Yahr stage of disease (P = 0.02), but not with duration of disease or age. IPSS scores did not correlate to stage of disease, duration of disease or age. Two arbitrary cut-offs were applied, identifying patients with significant LUTS, Dan-PSS > 10 and IPSS > 10. There were no significant differences between the age or duration of disease of patients with and without significant LUTS. The most frequent symptom was nocturia (IPSS: 86%) followed by frequency (IPSS: 71%) and urgency (IPSS: 68%). The most frequently reported bothersome bladder symptom was urgency (Dan-PSS: 61%), followed by nocturia (Dan-PSS: 50%) and urge incontinence (Dan-PSS: 44%). The prevalence of bothersome frequency is low (Dan-PSS: 37%). The postmicturitional volumes (PMV) did not correlate to stage of disease, duration of disease or age, or to scores on questionnaires. Mean PMV was 34 ml. Seven patients (6%) with PD had a PMV larger then 100 ml.
The prevalence of severe LUTS was similar with other studies, but the correlation between Dan-PSS and stage of disease, and not IPSS indicates that despite seeing no increase in frequency and severity of LUTS as PD progresses, patients find symptoms more bothersome. This may be due to progression in gait difficulties or a decreasing ability to separate and integrate sensory input, or both.
基于未考虑困扰程度的有效问卷，帕金森病（PD）患者下尿路症状（LUTS）的患病率报告为27%-39%。为了评估PD患者中LUTS的患病率、症状严重程度、排尿后残余尿量，并评估与因泌尿系统评估前来就诊的非PD患者的差异。
使用两套关于LUTS的有效问卷（丹麦前列腺症状评分量表[Dan-PSS]和国际前列腺症状评分量表[IPSS]）对107例PD患者进行评估；记录排尿后残余尿量，并与61例在泌尿外科门诊就诊的非PD患者进行比较。
使用Dan-PSS评分测量的困扰性LUTS与疾病的Hoehn和Yahr分期显著相关（P = 0.02），但与病程或年龄无关。IPSS评分与疾病分期、病程或年龄均无相关性。应用了两个任意的临界值来识别有显著LUTS的患者，即Dan-PSS>10和IPSS>10。有显著LUTS和无显著LUTS患者的年龄或病程之间无显著差异。最常见的症状是夜尿（IPSS：86%），其次是尿频（IPSS：71%）和尿急（IPSS：68%）。最常报告的困扰性膀胱症状是尿急（Dan-PSS：61%），其次是夜尿（Dan-PSS：50%）和急迫性尿失禁（Dan-PSS：44%）。困扰性尿频的患病率较低（Dan-PSS：37%）。排尿后尿量（PMV）与疾病分期、病程或年龄以及问卷评分均无相关性。平均PMV为34ml。7例（6%）PD患者的PMV大于100ml。
严重LUTS的患病率与其他研究相似，但Dan-PSS与疾病分期相关，而IPSS不相关，这表明尽管随着PD进展LUTS的频率和严重程度没有增加，但患者发现症状更困扰人。这可能是由于步态困难的进展或分离和整合感觉输入能力的下降，或两者兼而有之。
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