Department of Urology, The Methodist Hospital, Houston, TX 77030, USA.
Mult Scler. 2013 Aug;19(9):1169-74. doi: 10.1177/1352458512474089. Epub 2013 Jan 21.
Our aims were to determine the prevalence of renal ultrasound (RUS) abnormalities over time in multiple sclerosis (MS) patients with lower urinary tract symptoms (LUTS).
Data were examined retrospectively from MS patients with LUTS, from 2000-2009. Study inclusion requirements were both baseline urodynamics (UD) and RUS data, with followup RUS at ≥ 12 months. Age, time since diagnosis (TSD), MS subtype and the UD/RUS results were evaluated for associations.
At presentation, 173 subjects underwent UD and RUS, but only 89 had a repeat RUS at ≥ 12 months. Median followup was 61 months. Initial RUS abnormalities were found in 10 (5.8%) subjects. At followup, upper urinary tract (UUT) abnormalities were seen in 11 (12.4%) subjects. Patients > 49 years old were more likely to have an abnormality (OR 0.181, 95% CI 0.037-0.892, p = 0.04). Patients with abnormal compliance were also more likely to have an abnormal followup RUS (OR 0.185, 95% CI 0.037-0.924, p = 0.04). No other demographic or UD factor was associated with RUS abnormalities.
The development of structural UUT changes is low in MS patients. Urodynamic studies are useful for LUTS treatment strategies in complicated patients, but UD does not appear to have much impact with regard to upper tract changes.
我们旨在确定伴有下尿路症状（LUTS）的多发性硬化症（MS）患者的肾脏超声（RUS）异常的随时间变化的发生率。
对伴有 LUTS 的 MS 患者进行回顾性数据分析，时间范围为 2000 年至 2009 年。研究纳入标准为基线时均行尿动力学（UD）和 RUS 检查，且随访时行 RUS 检查的时间间隔≥12 个月。评估年龄、诊断后时间（TSD）、MS 亚型以及 UD/RUS 结果与异常之间的关系。
在初始时，173 例患者进行了 UD 和 RUS 检查，但仅有 89 例患者在≥12 个月时进行了重复 RUS 检查。中位随访时间为 61 个月。初始 RUS 异常者 10 例（5.8%）。随访时，11 例（12.4%）患者出现上尿路（UUT）异常。年龄大于 49 岁的患者更有可能出现异常（OR 0.181，95%CI 0.037-0.892，p=0.04）。顺应性异常的患者也更有可能出现异常的随访 RUS（OR 0.185，95%CI 0.037-0.924，p=0.04）。其他人口统计学或 UD 因素与 RUS 异常均无关。
MS 患者的 UUT 结构变化发生率较低。尿动力学研究对伴有 LUTS 的复杂患者的治疗策略有用，但 UD 对 UUT 变化的影响似乎不大。
