Kisic Tepavcevic Darija, Pekmezovic Tatjana, Dujmovic Basuroski Irena, Mesaros Sarlota, Drulovic Jelena
Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26, Belgrade, 11000, Serbia.
Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 6, Belgrade, 11000, Serbia.
Acta Neurol Belg. 2017 Mar;117(1):83-90. doi: 10.1007/s13760-016-0741-z. Epub 2017 Jan 13.
Bladder dysfunction (BD) is the most common autonomic disturbance in multiple sclerosis, but often overlooked and undertreated. The purpose of this longitudinal study was to explore the changes in the frequency of BD symptoms in MS cohort after a period of 3 and 6 years of follow-up, as well as to investigate the correlations between the presence of BD symptoms and both clinical characteristics and the health-related quality of life (HRQoL) at each subsequent point of estimation. The study population comprises a cohort of 93 patients with MS (McDonald's criteria, 2001). At each time point (baseline, and at the 3- and 6-year follow-up) of estimation, Expanded Disability Status Scale, Hamilton Rating Scale for Depression, Fatigue Severity Scale, Szasz Sexual Functioning Scale and HRQoL (measured by MSQoL-54) were assessed. The proportion of patients with at least one symptom of BD significantly increased over time, for both men and women (from 48.1% at baseline to 51.9% after 3 years and to 71.4% after 6 years of follow-up for males and from 45.5% at baseline to 50.0% after 3 years and to 66.7% after 6 years of follow-up for females). The most common BD problem was urgency of urination. The presence of BD was statistically significantly associated with higher level of physical disability, sexual dysfunction and HRQoL at each point of follow-up, for both men and women. Our results suggested outstanding frequency of BD in patients with MS, with increasing tendency over time.
膀胱功能障碍（BD）是多发性硬化症中最常见的自主神经功能紊乱，但常常被忽视且治疗不足。这项纵向研究的目的是探讨在随访3年和6年后，多发性硬化症队列中BD症状发生频率的变化，以及在随后的每个评估点，研究BD症状的存在与临床特征和健康相关生活质量（HRQoL）之间的相关性。研究人群包括93例符合2001年麦克唐纳标准的多发性硬化症患者。在每个评估时间点（基线、3年和6年随访），评估扩展残疾状态量表、汉密尔顿抑郁评定量表、疲劳严重程度量表、萨斯性功能量表和HRQoL（通过MSQoL-54测量）。随着时间的推移，至少有一项BD症状的患者比例显著增加，男性和女性均如此（男性从基线时的48.1%增加到3年后的51.9%，6年后的71.4%；女性从基线时的45.5%增加到3年后的50.0%，6年后的66.7%）。最常见的BD问题是尿急。在每个随访点，BD的存在与男性和女性较高水平的身体残疾、性功能障碍和HRQoL在统计学上显著相关。我们的结果表明，多发性硬化症患者中BD的发生率很高，且随时间有增加趋势。
