咳嗽时盆底肌肉活动：压力性尿失禁女性的模式改变
Pelvic floor muscle activity during coughing: altered pattern in women with stress urinary incontinence.
作者信息
Deffieux Xavier, Hubeaux Katelyne, Porcher Raphael, Ismael Samer Sheikh, Raibaut Patrick, Amarenco Gérard
机构信息
Université Pierre et Marie Curie, Paris 6, Faculté de Médecine, Paris, France.
出版信息
Urology. 2007 Sep;70(3):443-7; discussion 447-8. doi: 10.1016/j.urology.2007.03.084.
OBJECTIVES
To assess the relationship between bladder pressure (BP) and pelvic floor muscle activity during coughing in women with stress urinary incontinence (SUI).
METHODS
External anal sphincter integrated electromyographic activity (EAS-EMGi) was recorded in 21 women using pregelled surface electrodes. The relationship between BP and EAS-EMGi activity was assessed during four successive coughs at 0, 200, and 400 mL of filling. We also compared this relationship in 6 women presenting with SUI and 4 continent women.
RESULTS
Among the considered models, a sigmoid relationship between EAS-EMGi and BP best described the data: EMGi = exp[a x (BP - b)]/(1 + exp[a x (BP - b)]). This relationship between EAS-EMGi and BP was significantly altered in women presenting with SUI (P <0.0001).
CONCLUSIONS
Women with SUI exhibited an altered pattern of the pelvic floor muscle response during successive coughing efforts. The lack of this modulation of pelvic floor muscle response to stress might be one of the pathophysiologic factors of SUI.
目的
评估压力性尿失禁（SUI）女性咳嗽期间膀胱压力（BP）与盆底肌肉活动之间的关系。
方法
使用预凝胶表面电极记录21名女性的肛门外括约肌综合肌电图活动（EAS - EMGi）。在充盈量为0、200和400 mL时连续咳嗽4次期间，评估BP与EAS - EMGi活动之间的关系。我们还比较了6名SUI女性和4名控尿正常女性的这种关系。
结果
在所考虑的模型中，EAS - EMGi与BP之间的S形关系最能描述数据：EMGi = exp[a x (BP - b)]/(1 + exp[a x (BP - b)])。SUI女性中EAS - EMGi与BP之间的这种关系发生了显著改变（P <0.0001）。
结论
SUI女性在连续咳嗽时盆底肌肉反应模式发生改变。盆底肌肉对压力反应缺乏这种调节可能是SUI的病理生理因素之一。
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