Lee Wei-Chia, Wu Chia-Ching, Wu Huey-Peir, Tai Tong-Yuan
Department of Urology, Hoping Branch of Taipei City Hospital, Tapei, Taiwan.
Urology. 2007 Apr;69(4):685-90. doi: 10.1016/j.urology.2007.01.016.
To study the presence of lower urinary tract symptoms and parameters of uroflowmetry in women with type 2 diabetes mellitus with and without bladder dysfunction versus healthy controls.
After eliminating the possible confounders that might cause bladder dysfunction, 182 female patients at a diabetic clinic were evaluated by the American Urological Association Symptom Index (AUA-SI) questionnaire and uroflowmetry with postvoid residual (PVR) urine volume estimate. Their data were compared with the data from 197 healthy women, frequency-matched by age.
Using a cutoff value of bladder voiding efficiency of less than 75% with a PVR greater than 50 mL but less than 100 mL, a PVR greater than 100 mL, or a total volume greater than 500 mL, 47 patients (25.8%) were stratified as having bladder dysfunction. These patients had a significantly greater mean AUA-SI score (mean +/- standard error of the mean 9.6 +/- 0.8, P <0.001), as well as a lower maximum uroflow value (15.2 +/- 1.2 mL/s, P <0.001) compared with the control groups. The odds ratio of each lower urinary tract symptom was significantly greater in this group, except for straining (P = 0.12). A high proportion with an intermittent uroflow pattern (odds ratio 4.42, P <0.001) was also noted. Compared with the healthy controls, the diabetic women had no bladder dysfunction and seemed unaffected by the lower urinary tract symptoms as defined by the AUA-SI scoring system, with the exception of nocturia (odds ratio 2.62, P = 0.006).
Women with diabetes may have an increased risk of nocturia even without bladder dysfunction. A high AUA-SI score and lower maximum uroflow are likely to be good markers for diabetic bladder dysfunction.
研究伴或不伴膀胱功能障碍的2型糖尿病女性患者下尿路症状及尿流率参数，并与健康对照者进行比较。
在排除可能导致膀胱功能障碍的混杂因素后，采用美国泌尿外科学会症状指数（AUA-SI）问卷及尿流率测定并估算残余尿量（PVR），对一家糖尿病诊所的182例女性患者进行评估。将她们的数据与197例年龄匹配的健康女性的数据进行比较。
采用膀胱排尿效率临界值低于75%且PVR大于50 mL但小于100 mL、PVR大于100 mL或总体积大于500 mL的标准，47例患者（25.8%）被分层为存在膀胱功能障碍。与对照组相比，这些患者的平均AUA-SI评分显著更高（平均±平均标准误9.6±0.8，P<0.001），最大尿流率值更低（15.2±1.2 mL/s，P<0.001）。除排尿费力外（P = 0.12），该组每种下尿路症状的比值比均显著更高。还注意到该组间歇性尿流模式的比例较高（比值比4.42，P<0.001）。与健康对照者相比，糖尿病女性除夜尿外（比值比2.62，P = 0.006），无膀胱功能障碍，且似乎未受AUA-SI评分系统所定义的下尿路症状影响。
即使没有膀胱功能障碍，糖尿病女性夜尿风险可能增加。较高的AUA-SI评分和较低的最大尿流率可能是糖尿病膀胱功能障碍的良好标志物。
