New England Research Institutes, Inc., Watertown, Massachusetts 02472, USA.
Neurourol Urodyn. 2012 Sep;31(7):1149-55. doi: 10.1002/nau.22232. Epub 2012 Jun 6.
To compare the descriptive epidemiology of overactive bladder (OAB) of presumed neurologic origin (NOAB) to OAB of non-neurologic origin (N-NOAB).
Five thousand five hundred three community-dwelling persons aged 30-79 were interviewed regarding urologic symptoms (2002-2005). NOAB was defined as symptoms of urgency and/or urgency incontinence among those with a self-reported history of healthcare provider diagnosed stroke (N = 98), multiple sclerosis (N = 21), or Parkinson's disease (N = 7). N-NOAB was defined identically but occurring among those not reporting neurologic disease (ND). Prevalence estimates were weighted to reflect sampling design; chi-square, Fisher's exact, or t-tests were used to test differences. Urologic symptom interference was assessed using the Epstein scale, while the impact of urinary incontinence (UI) on health-related quality-of-life (HRQOL) was measured using a modification of the Incontinence Impact Questionnaire-7.
Forty-five (31.0%) of 125 persons with ND and 994 (16.7%) of 5378 persons without ND reported OAB symptoms. The overall prevalence of NOAB and N-NOAB was 0.6% and 16.4%, respectively. Persons with NOAB had higher (worse) mean American Urologic Association Symptom Index scores (13.0 vs. 10.0, P = 0.09) compared to those with N-NOAB, and were significantly more likely to have diabetes, high blood pressure, cardiac disease, and fair/poor self-reported health (all P < 0.05). Mean symptom interference and UI HRQOL scores were significantly higher (worse) in the NOAB group compared to persons with N-NOAB (all P < 0.05).
Persons with NOAB appeared to have a greater burden of urologic illness with respect to symptom interference and HRQOL compared to persons with N-NOAB.
比较推定神经源性膀胱过度活动症(OAB)与非神经源性 OAB 的描述性流行病学。
对 5503 名年龄在 30-79 岁的社区居民进行了关于泌尿系统症状的访谈(2002-2005 年)。NOAB 定义为有医疗保健提供者诊断的中风(N=98)、多发性硬化症(N=21)或帕金森病(N=7)病史的患者中出现尿急和/或急迫性尿失禁的症状。N-NOAB 通过同样的方法定义,但发生在没有报告神经疾病(ND)的患者中。使用加权估计患病率以反映抽样设计;使用卡方检验、Fisher 确切概率检验或 t 检验来检验差异。使用 Epstein 量表评估泌尿系统症状的干扰,使用对失禁影响问卷-7 的修改版来衡量尿失禁(UI)对健康相关生活质量(HRQOL)的影响。
45 名(31.0%)ND 患者和 5378 名(16.7%)无 ND 患者报告了 OAB 症状。NOAB 和 N-NOAB 的总体患病率分别为 0.6%和 16.4%。NOAB 患者的平均美国泌尿协会症状指数评分(13.0 分比 10.0 分,P=0.09)高于 N-NOAB 患者,并且更有可能患有糖尿病、高血压、心脏病和自我报告的健康状况一般/较差(均 P<0.05)。NOAB 组的平均症状干扰和 UI HRQOL 评分明显高于 N-NOAB 组(均 P<0.05)。
与 N-NOAB 患者相比,NOAB 患者的泌尿系统疾病负担似乎更大,包括症状干扰和 HRQOL。