Interdisciplinary Centre for Palliative Care, Klinikum der Universität München, Ludwig-Maximilians-University Munich , Germany.
Amyotroph Lateral Scler Frontotemporal Degener. 2014 Jun;15(3-4):174-9. doi: 10.3109/21678421.2013.868001. Epub 2014 Jan 31.
Amyotrophic lateral sclerosis (ALS) is predominantly characterized by a progressive loss of motor function. While autonomic dysfunction has been described in ALS, little is known about the prevalence of lower urinary tract symptoms (LUTS) and intestinal dysfunction. We investigated disease severity, LUTS and intestinal dysfunction in 43 patients with ALS attending our outpatient department applying the ALS functional rating scale, the International Consultation on Incontinence Modular Questionnaire, the Urinary Distress Inventory and the Cleveland Clinic Incontinence Score. Results were compared to the German population of a cross-sectional study assessing LUTS in the healthy population, the EPIC study. Results showed that urinary incontinence was increased in patients with ALS aged ≥ 60 years compared to the EPIC cohort (female: 50%/19% (ALS/EPIC), p = 0.026; male: 36%/11% (ALS/EPIC), p = 0.002). No difference was seen at 40-59 years of age. Urge incontinence was the predominant presentation (73% of symptoms). A high symptom burden was stated (ICIQ-SF quality of life subscore 5.5/10). Intake of muscle relaxants and anticholinergics was associated with both urinary incontinence and severity of symptoms. Furthermore, a high prevalence of constipation (46%), but not stool incontinence (9%), was noted. In conclusion, the increased prevalence of urge incontinence and high symptom burden imply that in patients with ALS, LUTS should be increasingly investigated for.
肌萎缩侧索硬化症（ALS）主要表现为运动功能进行性丧失。虽然在 ALS 中已经描述了自主神经功能障碍，但对于下尿路症状（LUTS）和肠道功能障碍的患病率知之甚少。我们应用 ALS 功能评定量表、国际尿失禁咨询问卷模块、尿困扰量表和克利夫兰诊所失禁评分，对 43 名在我们门诊部就诊的 ALS 患者的疾病严重程度、LUTS 和肠道功能障碍进行了研究。结果与一项评估健康人群 LUTS 的横断面研究 EPIC 研究中的德国人群进行了比较。结果表明，与 EPIC 队列相比，年龄≥60 岁的 ALS 患者的尿失禁发生率增加（女性：50%/19%（ALS/EPIC），p=0.026；男性：36%/11%（ALS/EPIC），p=0.002）。在 40-59 岁时没有差异。急迫性尿失禁是主要表现（73%的症状）。患者报告的症状负担很重（ICIQ-SF 生活质量亚量表 5.5/10）。肌肉松弛剂和抗胆碱能药物的摄入与尿失禁和症状严重程度均有关。此外，还注意到便秘的高患病率（46%），但无粪便失禁（9%）。总之，急迫性尿失禁的患病率增加和高症状负担表明，在 ALS 患者中，LUTS 应越来越受到关注。
