School of Nursing, University of North Carolina, Chapel Hill, North Carolina 27704, USA.
J Urol. 2009 Jul;182(1):196-202. doi: 10.1016/j.juro.2009.02.115. Epub 2009 May 17.
We explored the nature of the relationship between heart failure and urinary symptoms, specifically urinary incontinence and overactive bladder.
An 81-item written survey about urinary incontinence, urgency, frequency, nocturia and other symptoms was administered to hospitalized and clinic patients with heart failure. A medical records review was also conducted to determine types of medications, body mass index and documentation of the New York Heart Association Classification of heart failure.
Of 408 respondents 296 (average age 62.2 years) had information about heart failure stage and urinary symptoms. Of these respondents 45% and 57% reported urinary incontinence and overactive bladder, respectively. Adjusted odds ratio for having overactive bladder over no symptoms for respondents with New York Heart Association Class III or Class IV heart failure was 2.9 (95% CI 1.344-6.250) and for higher fatigue-depression composite was 2.155 (95% CI 1.206-3.860). Adjusted odds ratio for having overactive bladder over frequency/nocturia for respondents with higher body mass index was 1.458 (95% CI 1.087-1.953) and for higher fatigue-depression composite was 1.629 (95% CI 1.038-2.550).
Urinary incontinence and overactive bladder are prevalent in patients with heart failure. Evidence of late stage heart failure, higher fatigue-depression composite and higher body mass index were associated with overactive bladder. Sex, age and diuretic use were not associated with urinary incontinence and overactive bladder.
我们探讨了心力衰竭与尿症状(特别是尿失禁和膀胱过度活动症)之间关系的本质。
对住院和门诊心力衰竭患者进行了一项关于尿失禁、尿急、频率、夜尿和其他症状的 81 项书面调查。还进行了病历回顾,以确定药物类型、体重指数和心力衰竭的纽约心脏协会分类的记录。
在 408 名应答者中,有 296 名(平均年龄 62.2 岁)有心力衰竭阶段和尿症状的信息。在这些应答者中,分别有 45%和 57%报告有尿失禁和膀胱过度活动症。纽约心脏协会 III 级或 IV 级心力衰竭患者中,有膀胱过度活动症而无症状的调整比值比为 2.9(95%可信区间 1.344-6.250),更高的疲劳-抑郁综合评分的调整比值比为 2.155(95%可信区间 1.206-3.860)。对于体重指数较高的患者,有膀胱过度活动症而无尿急/夜尿的调整比值比为 1.458(95%可信区间 1.087-1.953),更高的疲劳-抑郁综合评分的调整比值比为 1.629(95%可信区间 1.038-2.550)。
尿失禁和膀胱过度活动症在心力衰竭患者中很常见。晚期心力衰竭的证据、更高的疲劳-抑郁综合评分和更高的体重指数与膀胱过度活动症有关。性别、年龄和利尿剂的使用与尿失禁和膀胱过度活动症无关。