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帕金森病排尿障碍的研究

Investigation of Urination Disorder in Parkinson's disease.

作者信息

Zhang Li-Mei, Zhang Xu-Ping

机构信息

Department of Neurology, Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, China.

出版信息

Chin Med J (Engl). 2015 Nov 5;128(21):2906-12. doi: 10.4103/0366-6999.168049.

Abstract

BACKGROUND

Urination disorders are common in Parkinson's disease (PD) and respond poorly to medication. This study aimed to analyze the risk factors for urination disorders in PD.

METHODS

Ninety-one patients with PD (aged 34-83 years old) were recruited. Patients were assessed with the Unified PD Rating Scale (UPDRS), Hoehn and Yahr stage, Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HAMD), and Hamilton Anxiety Scale (HAMA). Micturition number was recorded, and Type B ultrasound was used to evaluate residual urine. Statistics was performed using binary logistic regression, bivariate correlations, and Chi-square and t-tests.

RESULTS

Of 91 patients, urinary dysfunction occurred in 55.0%. Among these, 49.5% suffered with nocturia, 47.3% with pollakiuria. Nocturia number had a positive linear relationship with HAMA score (odds ratio [OR] = 0.340, P = 0.001), HAMD score (OR = 0.323, P = 0.002), duration of L-dopa medication (OR = 0.328, P = 0.001), dose of L-dopa (OR = 0.273, P = 0.009), UPDRS-II (OR = 0.402, P = 0.000), UPDRS-III score (OR = 0.291, P = 0.005), and PSQI score (OR = 0.249, P = 0.017). Micturition number over 24 h was positively associated with HAMA (OR = 0.303, P = 0.004) and UPDRS-II scores (OR = 0.306, P = 0.003). Of patients with residual urine, 79.3% had a volume of residual urine <50 ml. Residual urine was present in 44.4% of the patients with nocturia, 46.5% of the patients with pollakiuria, and 80.0% of the patients with dysuria. More men than women had residual urine (35.2% male vs. 13.3% female; P = 0.002).

CONCLUSIONS

Nocturia and pollakiuria were common micturition symptoms in our participants with PD. Nocturia was associated with depression, anxiety, sleep problems, and severity of PD. Pollakiuria was associated with anxiety and severity of PD. Male patients were more prone to residual urine and pollakiuria.

摘要

背景

排尿障碍在帕金森病(PD)中很常见,药物治疗效果不佳。本研究旨在分析PD患者排尿障碍的危险因素。

方法

招募了91例PD患者(年龄34 - 83岁)。使用统一帕金森病评定量表(UPDRS)、Hoehn和Yahr分期、匹兹堡睡眠质量指数(PSQI)、汉密尔顿抑郁评定量表(HAMD)和汉密尔顿焦虑量表(HAMA)对患者进行评估。记录排尿次数,并用B型超声评估残余尿量。采用二元逻辑回归、双变量相关性分析以及卡方检验和t检验进行统计学分析。

结果

91例患者中,55.0%出现排尿功能障碍。其中,49.5%有夜尿症,47.3%有多尿症。夜尿次数与HAMA评分呈正线性关系(比值比[OR]=0.340,P = 0.001)、HAMD评分(OR = 0.323,P = 0.002)、左旋多巴用药时长(OR = 0.328,P = 0.001)、左旋多巴剂量(OR = 0.273,P = 0.009)、UPDRS - II(OR = 0.402,P = 0.000)、UPDRS - III评分(OR = 0.291,P = 0.005)和PSQI评分(OR = 0.249,P = 0.017)。24小时排尿次数与HAMA(OR = 0.303,P = 0.004)和UPDRS - II评分呈正相关(OR = 0.306,P = 0.003)。在有残余尿量的患者中,79.3%的残余尿量<50 ml。夜尿症患者中有44.4%存在残余尿,多尿症患者中有46.5%存在残余尿,排尿困难患者中有80.0%存在残余尿。男性有残余尿的比例高于女性(男性35.2% vs.女性13.3%;P = 0.002)。

结论

夜尿症和多尿症是我们研究的PD患者常见的排尿症状。夜尿症与抑郁、焦虑、睡眠问题及PD严重程度相关。多尿症与焦虑及PD严重程度相关。男性患者更易出现残余尿和多尿症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7708/4756881/8f9212d08ce5/CMJ-128-2906-g001.jpg

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