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[夜尿症的临床研究进展]

[Advances in clinical study of nocturia].

作者信息

Guan Zhi-chen

机构信息

Department of Urology, Peking University Shenzhen Hospital, Shenzhen 518036, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2010 Aug 18;42(4):487-92.

Abstract

Nocturia is one of the most common reasons for interrupted sleep in general adult population. The condition affects both men and women, with an incidence that increases dramatically with age. Nocturia has a negative impact on quality of life, affecting both morbidity and mortality. International Continence Society (ICS) issued a report of terminology standardization in 2002, in which nocturia is defined as waking during the night at least once to urinate. Nocturia is a common complaint in elderly population. Although most cases of nocturia are assumed to be caused by urologic problems, the interacting effects of aging and sleep on renal and urinary function, in fact, cause nocturia in the elderly. Effective diagnosis of the condition is dependent on a clear understanding of its underlying etiology. Multiple factors may cause nocturia, such as behavioral or environmental factors and pathologic conditions. In general, the causes of nocturia fall into three categories: diurnal polyuria, nocturnal polyuria, and low bladder capacity. Careful evaluation of medications and underlying medical conditions is essential for the proper management of nocturia. A voiding diary is necessary to diagnose the syndrome of nocturnal polyuria, which is a common cause of nocturia. Addressing any underlying conditions that contribute to nocturia is the first step in treating the condition. Lifestyle and behavioral changes may provide benefit in some individuals, but for many cases, pharmacotherapy is the best option. Antimuscarinic agents are first-line therapies for overactive bladder and are often used in the management of nocturia. Current treatment options also include desmopressin, a synthetic analog of arginine vasopressin, which can increase urinary osmolality and decrease total urinary volume. The desmopressin therefore increases the length of time until the first nocturnal void and decreases the number of nocturnal voids, the NUV voided, and the percentage of urine voided at night.

摘要

夜尿症是一般成年人群睡眠中断的最常见原因之一。这种情况在男性和女性中都会出现,其发病率会随着年龄的增长而急剧上升。夜尿症会对生活质量产生负面影响,同时影响发病率和死亡率。国际尿控协会(ICS)在2002年发布了一份术语标准化报告,其中夜尿症被定义为夜间至少醒来排尿一次。夜尿症是老年人群中的常见主诉。虽然大多数夜尿症病例被认为是由泌尿系统问题引起的,但实际上衰老和睡眠对肾脏及泌尿功能的相互作用才导致了老年人的夜尿症。对该病症的有效诊断取决于对其潜在病因的清晰理解。多种因素可能导致夜尿症,如行为或环境因素以及病理状况。一般来说,夜尿症的病因可分为三类:日间多尿、夜间多尿和膀胱容量低。仔细评估药物和潜在的医疗状况对于夜尿症的恰当管理至关重要。排尿日记对于诊断夜间多尿综合征是必要的,而夜间多尿综合征是夜尿症的常见病因。处理任何导致夜尿症的潜在状况是治疗该病症的第一步。生活方式和行为改变可能对某些个体有益,但在许多情况下,药物治疗是最佳选择。抗胆碱能药物是治疗膀胱过度活动症的一线疗法,常用于夜尿症的管理。目前的治疗选择还包括去氨加压素,一种精氨酸加压素的合成类似物,它可以增加尿渗透压并减少总尿量。因此,去氨加压素可延长直至首次夜间排尿的时间,并减少夜间排尿次数、夜间排尿量以及夜间排尿占总尿量的百分比。

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