Wheeler J S, Culkin D J, Canning J R
Department of Urology, Loyola University Medical Center, Maywood, Illinois.
Urology. 1988 Jan;31(1):86-9. doi: 10.1016/0090-4295(88)90584-5.
A positive bethanechol supersensitivity test (BST) usually indicates neuropathic detrusor areflexia and warrants neurologic correlation. Seven females, average age thirty-three years, with straining to void and high residual urines, had detrusor areflexia, with a borderline or positive BST, ranging from 19 cm water to 55 cm H2O change in intravesical pressure after 5 mg of subcutaneous bethanechol. However, all patients had a normal neurologic workup, even though 2 patients had insignificant spina bifida occulta. Two of the patients also had prior pelvic surgery, 1 of whom was azotemic, and 4 of the patients had psychosocial problems; factors reported to be associated with a false positive BST. The positive BST is not diagnostic of neurogenic detrusor areflexia because of the many variables that can influence the test. Therefore, the bethanechol supersensitivity test should be interrupted in light of the complete neurourologic evaluation.
阳性的氨甲酰甲胆碱超敏试验（BST）通常提示神经源性逼尿肌无反射，并需要进行神经学相关检查。七名平均年龄为33岁的女性，存在排尿费力和高残余尿量，有逼尿肌无反射，BST处于临界或阳性，皮下注射5毫克氨甲酰甲胆碱后膀胱内压变化范围为19厘米水柱至55厘米水柱。然而，所有患者的神经学检查均正常，尽管有两名患者存在轻微隐性脊柱裂。其中两名患者既往有盆腔手术史，一名患者有氮质血症，四名患者有社会心理问题；这些因素据报道与假阳性BST相关。由于有许多变量可影响该试验，阳性BST不能诊断神经源性逼尿肌无反射。因此，鉴于完整的神经泌尿学评估，应中断氨甲酰甲胆碱超敏试验。
