Komatsu K, Nagano K, Yokoyama O, Kawaguchi K, Hisazumi H, Hayashi S
Department of Urology, Kanazawa University School of Medicine.
Hinyokika Kiyo. 1991 Jan;37(1):25-9.
During a period of 4.5 years, neurological and urodynamic evaluation was done on 12 patients with multiple sclerosis between 20 and 67 years old with an average age of 47.6 years. Pyramidal dysfunction (100%), sensory disturbance (100%) and brain stem dysfunction (60%) were common neurological signs. All patients were assessed by the Kurtzke's rating of neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Of the 12 cases 6 were diagnosed as severe multiple sclerosis (EDSS greater than or equal to 4.5) and the remainders were diagnosed as relatively mild (EDSS less than 4.5). Neurourologic evaluation was performed by rapid filling carbon dioxide cystometry and sphincter electromyography. Cystometry revealed overactive bladder in 4 (33%), underactive bladder in 3 (25%) and normoactive bladder in 5 (42%) of the 12 cases. Of the 6 severe cases of multiple sclerosis, 3 (50%) showed overactive bladder, while only 1 of the 6 (17%) mild cases showed overactive bladder. Detrusor sphincter dyssynergia (DSD) was observed in 4 of the 9 (67%) severe cases and none of the 6 mild cases. The presence of overactive bladder or DSD seems to correlate with the severity of multiple sclerosis.
在4.5年的时间里，对12例年龄在20至67岁之间、平均年龄为47.6岁的多发性硬化症患者进行了神经学和尿动力学评估。锥体功能障碍（100%）、感觉障碍（100%）和脑干功能障碍（60%）是常见的神经学体征。所有患者均通过库尔特克多发性硬化症神经功能损害评分：扩展残疾状态量表（EDSS）进行评估。12例患者中，6例被诊断为重度多发性硬化症（EDSS大于或等于4.5），其余患者被诊断为相对轻度（EDSS小于4.5）。通过快速充盈二氧化碳膀胱测压法和括约肌肌电图进行神经泌尿学评估。膀胱测压显示，12例患者中有4例（33%）膀胱过度活动，3例（25%）膀胱活动不足，5例（42%）膀胱功能正常。在6例重度多发性硬化症患者中，3例（50%）表现为膀胱过度活动，而6例轻度患者中只有1例（17%）表现为膀胱过度活动。9例重度患者中有4例（67%）观察到逼尿肌括约肌协同失调（DSD），6例轻度患者中无一例出现。膀胱过度活动或DSD的存在似乎与多发性硬化症的严重程度相关。
