Xu Duo, Han Shunchang, Wang Jue, Feng Juan
Department of Neurology, Shengjing Hospital, Affiliated Hospital of China Medical University, No. 36 Sanhao Street, Shen Yang 110004, China.
Parkinsons Dis. 2019 Mar 5;2019:6820937. doi: 10.1155/2019/6820937. eCollection 2019.
Lower urinary tract (LUT) dysfunction is very common in Parkinson's disease (PD) patients. However, the number of studies conducted on LUT dysfunction and its related factors in Chinese PD patients is very limited, and there is no international consensus concerning the results.
This cross-sectional study enrolled 100 Chinese PD patients. The patients were classified based on their overactive bladder symptom score (OABSS) and then assigned to either a PD with overactive bladder (PD-OAB) group or a PD with no overactive bladder (PD-NOAB) group. A binary logistic regression analysis was performed to identify the accompanying factors for overactive bladder (OAB). Next, correlations between the OABSS and patient sex, age, age of onset, disease duration, MDS-UPDRS-III, H-Y stage, PD subtype, treatment, education, and nonmotor symptoms were analyzed to identify factors correlated with LUT dysfunction.
Eighty nine (89%) of the PD patients suffered from LUT dysfunction, and OAB was diagnosed in 45 (45%) of those PD patients. The most common lower urinary tract (LUT) symptom in the PD patients was nighttime frequency (86%), followed by urgency (50%), urge incontinence (34%), and daytime frequency (17%). Patients in the PD-OAB group had an older age and age of onset, were at a more advanced Hoehn-Yahr stage, and had more severe motor symptoms and nonmotor symptoms, including worse cognition, and a greater incidence of REM sleep behavior disorder (RBD). A binary logistic regression analysis showed that a lower Frontal Assessment Battery (FAB) score, higher H-Y stage, and RBD accompanied with a higher prevalence of OAB in PD patients. A multiple linear regression analysis showed that the OABSS was significantly influenced by the FAB score, H-Y stage, RBD, and age.
The FAB score, H-Y stage, and RBD are accompanying factors for OAB. A higher OABSS in PD patients was related to a lower FAB score for frontal lobe executive dysfunction, a higher H-Y stage for severity of motor disorders, RBD, and an older age.
下尿路（LUT）功能障碍在帕金森病（PD）患者中非常常见。然而，针对中国PD患者下尿路功能障碍及其相关因素的研究数量非常有限，且研究结果尚无国际共识。
这项横断面研究纳入了100名中国PD患者。根据膀胱过度活动症状评分（OABSS）对患者进行分类，然后将其分为膀胱过度活动的PD（PD - OAB）组或无膀胱过度活动的PD（PD - NOAB）组。进行二元逻辑回归分析以确定膀胱过度活动（OAB）的伴随因素。接下来，分析OABSS与患者性别、年龄、发病年龄、病程、MDS - UPDRS - III、H - Y分期、PD亚型、治疗、教育程度和非运动症状之间的相关性，以确定与LUT功能障碍相关的因素。
89%的PD患者存在LUT功能障碍，其中45%（45例）被诊断为OAB。PD患者中最常见的下尿路（LUT）症状是夜尿（86%），其次是尿急（50%）、急迫性尿失禁（34%）和日间尿频（17%）。PD - OAB组患者年龄和发病年龄较大，Hoehn - Yahr分期更晚，运动症状和非运动症状更严重，包括认知功能更差，快速眼动睡眠行为障碍（RBD）的发生率更高。二元逻辑回归分析表明，较低的额叶评估量表（FAB）评分、较高的H - Y分期以及RBD与PD患者中较高的OAB患病率相关。多元线性回归分析表明，OABSS受FAB评分、H - Y分期、RBD和年龄的显著影响。
FAB评分、H - Y分期和RBD是OAB的伴随因素。PD患者中较高的OABSS与额叶执行功能障碍的较低FAB评分、运动障碍严重程度较高的H - Y分期、RBD以及较高年龄有关。
