Weinstein M S, Cardenas D D, O'Shaughnessy E J, Catanzaro M L
Department of Rehabilitation Medicine, University of Washington, Seattle.
Arch Phys Med Rehabil. 1988 Nov;69(11):923-7.
Ninety-one subjects with multiple sclerosis were evaluated by carbon dioxide cystometry in the supine, sitting, and standing positions, and by water cystometry in the supine position. Detrusor responses in supine studies were characterized as normal, hyperreflexic, or areflexic. Carbon dioxide and water cystometry were without difference in determining types of detrusor responses. Positional changes (particularly standing) resulted in reassessing of normal supine bladder responses as hyperreflexic. Hyperreflexia was aggravated with sitting and standing. Positional changes did not demonstrate conversion of areflexia to hyperreflexia. The relatively small proportion of dyssynergic sphincter responses probably represents a population of patients with early stage multiple sclerosis. Carbon dioxide cystometry, with positional changes, is relatively safe, easily performed, and an accurate method of evaluating detrusor response in patients with multiple sclerosis who have a changing clinical course or unresponsiveness to treatment.
91名多发性硬化症患者接受了评估，分别在仰卧位、坐位和站立位进行二氧化碳膀胱测压，并在仰卧位进行水膀胱测压。仰卧位研究中的逼尿肌反应分为正常、反射亢进或无反射。二氧化碳和水膀胱测压在确定逼尿肌反应类型方面没有差异。体位变化（尤其是站立）导致将正常的仰卧位膀胱反应重新评估为反射亢进。反射亢进在坐位和站立位时加重。体位变化未显示无反射转变为反射亢进。协同失调的括约肌反应比例相对较小，这可能代表了早期多发性硬化症患者群体。二氧化碳膀胱测压结合体位变化相对安全、易于操作，是评估临床病程变化或对治疗无反应的多发性硬化症患者逼尿肌反应的准确方法。
