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[夜尿症、发病率、病因、诊断]

[Nocturia, incidence, ethiology, diagnostics].

作者信息

Zachoval R, Krhut J, Sottner O, Hanuš T, Martan A, Horčička L, Feyereisl J, Halaška M, Svabík K, Krofta L

出版信息

Ceska Gynekol. 2013 Dec;78(6):566-72.

Abstract

Nocturia is the complaint that the individual has to wake at night one or more times to void, according to the International Continence Society definition from the ICS Standardisation of Terminology Report 2002. As the nocturia definition is complicated there are also other slightly modified definitions. It is currently not absolutely clear if prevalence or incidence is more important for epidemiology evaluation of nocturia. Nocturia is a variable symptom and its presence in individuals is reversible therefore it is very difficult to obtain reliable incidence data. Nocturia prevalence varies remarkably in different studies according to evaluation methodology, nocturia definition, methods of data collection and characteristics of evaluated population. There are not enough studies, especially demographic ones, evaluating lower urinary tract symptoms and/or nocturia in males and females. There is relatively large number of comparative studies confirming strong correlation between aging and prevalence of nocturia. Prevalence of two or more voids per night in individuals in their twenties varies between 5-15 %, it progresses with age, and in the seventh decade of life ranges between 35-50 %. Prevalence evaluated by gender is higher among younger women compared to older women and older men compared to younger men. Currently there are only limited sources of data regarding nocturia incidence. Incidence of nocturia (two or more voids per night) in a population older than 60 years is 213 new cases/1000 persons/1 year in two year observation. Incidence of two or more voids per night is 75 new cases/1000 male/1 year in five year observation and 126 new cases/1000 male/1 year in ten year observation in male population. Incidence of nocturia rises significantly with age. Incidence of two or more voids per night increases by 2,7 % in the population of women after child birth during 5 year follow up and by 5,9 % during 12 year follow up. Incidence of nocturia newly diagnosed in a pregnancy drops down by 98% in 3 month after the child birth. The incidence data indicate that incidence of nocturia rises with age and probability of nocturia relief decreases with age. Incidence of mild nocturia is higher compared to incidence of severe nocturia and significant relief of nocturia in women after child birth is very inconsistent compared to increase of other lower urinary tract symptoms. Ethiology of nocturia might be polyuria, nocturnal polyuria or reduced bladder capacity. Nocturia and its ethiology can be determined in most cases with simple and commonly used investigative methods on the out-patients bases. The diagnostic algorithm should lead to verification of nocturia and identifying its cause because treatment of nocturia differs remarkably according to the etiology.

摘要

根据国际尿控协会(ICS)2002年术语标准化报告中的定义,夜尿症是指个体夜间不得不醒来排尿一次或多次的主诉。由于夜尿症的定义较为复杂,也存在其他略有修改的定义。目前尚不完全清楚患病率或发病率对于夜尿症的流行病学评估哪个更重要。夜尿症是一种可变症状,其在个体中的出现是可逆的,因此很难获得可靠的发病率数据。根据评估方法、夜尿症定义、数据收集方法和评估人群的特征,不同研究中夜尿症的患病率差异显著。评估男性和女性下尿路症状和/或夜尿症的研究不足,尤其是人口统计学方面的研究。有相当数量的比较研究证实衰老与夜尿症患病率之间存在强相关性。二十多岁的个体中每晚排尿两次或更多次的患病率在5%-15%之间,随年龄增长而上升,在七十岁时则在35%-50%之间。按性别评估的患病率,年轻女性高于老年女性,老年男性高于年轻男性。目前关于夜尿症发病率的数据来源有限。在两年的观察中,60岁以上人群中夜尿症(每晚排尿两次或更多次)的发病率为每1000人每年213例新发病例。在男性人群中,五年观察期内每晚排尿两次或更多次的发病率为每1000名男性每年75例新发病例,十年观察期内为每1000名男性每年126例新发病例。夜尿症的发病率随年龄显著上升。产后女性人群在5年随访期间每晚排尿两次或更多次的发病率增加2.7%,12年随访期间增加5.9%。产后3个月内新诊断的夜尿症发病率下降98%。发病率数据表明,夜尿症发病率随年龄上升,夜尿症缓解的可能性随年龄下降。轻度夜尿症的发病率高于重度夜尿症,与其他下尿路症状的增加相比,产后女性夜尿症的显著缓解非常不一致。夜尿症的病因可能是多尿、夜间多尿或膀胱容量减少。在大多数情况下,夜尿症及其病因可以通过门诊常用的简单检查方法来确定。诊断算法应导致夜尿症的确诊并确定其病因,因为根据病因不同,夜尿症的治疗方法差异很大。

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