Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
Neurourol Urodyn. 2013 Jun;32(5):428-34. doi: 10.1002/nau.22336. Epub 2012 Nov 5.
Overactive bladder (OAB) affects the daily life of many stroke victims. In contrast to urinary incontinence, little is known about the prevalence and risk factors for OAB among stroke patients. Therefore, we conducted a questionnaire survey and analyzed the results together with the clinical data and MRI findings.
A total of 500 volunteer patients with chronic-phase stroke were enrolled. The overactive bladder symptom score (OABSS), Short Form 8 (SF-8) health survey questionnaire, and some key international questionnaires about urinary dysfunction were assessed.
We diagnosed 141 patients (28%) with OAB, among whom 103 (73%) had never been treated for their symptoms. Patients with OAB showed lower scores in both the physical and mental components of the SF-8, which suggested the burden of OAB on the quality of life of stroke patients. Advanced age and male gender were closely related to high OABSS. The modified Rankin Scale (mRS) was positively correlated with OABSS. Patients with cerebral infarction and those with intracerebral hemorrhage showed a similarly high OABSS. The severity of deep white-matter hyperintensity on MRI, classified by the 4-grade Fazekas scoring system, was significantly associated with high OABSS irrespective of presence of accompanying infarcts. Patients with cerebral infarcts in the region of anterior circulation showed a higher OABSS than those with cerebral infarcts in the posterior circulation.
Based on the present risk analysis, patient care should be preferentially focused on the detection and treatment of OAB to improve the quality of life of stroke patients.
膀胱过度活动症(OAB)会影响许多中风患者的日常生活。与尿失禁不同,中风患者 OAB 的患病率和风险因素知之甚少。因此,我们进行了问卷调查,并结合临床数据和 MRI 结果进行了分析。
共纳入 500 名慢性期中风的志愿者患者。评估了膀胱过度活动症症状评分(OABSS)、简明健康调查问卷 8 项(SF-8)和一些关于尿功能障碍的关键国际问卷。
我们诊断出 141 名(28%)患者患有 OAB,其中 103 名(73%)患者从未接受过症状治疗。OAB 患者的 SF-8 身体和心理成分得分均较低,这表明 OAB 对中风患者生活质量的负担。高龄和男性与高 OABSS 密切相关。改良 Rankin 量表(mRS)与 OABSS 呈正相关。脑梗死和脑出血患者的 OABSS 均较高。MRI 上的深部白质高信号严重程度(按 4 级 Fazekas 评分系统分类)与高 OABSS 显著相关,无论是否伴有梗死。前循环脑梗死患者的 OABSS 高于后循环脑梗死患者。
基于目前的风险分析,应优先关注 OAB 的检测和治疗,以提高中风患者的生活质量。