Guite H F, Bliss M R, Mainwaring-Burton R W, Thomas J M, Drury P L
Department of Geriatric Medicine, Hackney Hospital, London.
Age Ageing. 1988 Jul;17(4):241-8. doi: 10.1093/ageing/17.4.241.
In view of recent investigations suggesting that the circadian rhythm of urine output is reversed in the elderly, the present study was designed to see if increased urine flow at night may be related to change in posture. Urine flow, urea and electrolyte excretion were measured 4-hourly for 6 consecutive days and nights in four catheterized female patients, mean age 83 years. Two were nursed in chairs for 8 h daily for 3 days, followed by total bed-rest for 3 days, and the other two in reverse order. None of the patients showed the morning rise of water and electrolyte excretion which has been described in young people. On full bed-rest, there was no significant day-night difference in water, sodium, potassium, urea or creatinine excretion. Chair nursing produced a negative mean day-night difference in water excretion (-321 ml: P less than 0.001) and in sodium (-11.7 mmol: P less than 0.002), urea (-26.6 mmol: P = 0.005) and creatinine excretion (-0.6 mmol: P = 0.008), but had no significant effect on potassium excretion. These results suggest that sitting upright may have important effects on water and electrolyte balance in elderly patients and may contribute to nocturia and nocturnal incontinence.
鉴于最近的研究表明老年人尿量的昼夜节律发生了逆转，本研究旨在探讨夜间尿量增加是否与体位变化有关。对4名平均年龄83岁的女性留置导尿患者连续6个昼夜每4小时测量一次尿量、尿素和电解质排泄量。其中2名患者先每天在椅子上坐8小时，持续3天，然后完全卧床休息3天，另外2名患者顺序相反。所有患者均未出现年轻人中所描述的水和电解质排泄量的晨起升高。完全卧床休息时，水、钠、钾、尿素或肌酐排泄量的昼夜差异不显著。坐椅护理导致水排泄量的平均昼夜差异为负值（-321毫升：P<0.001），钠排泄量（-11.7毫摩尔：P<0.002）、尿素排泄量（-26.6毫摩尔：P=0.005）和肌酐排泄量（-0.6毫摩尔：P=0.008），但对钾排泄量无显著影响。这些结果表明，直立坐姿可能对老年患者的水和电解质平衡有重要影响，并可能导致夜尿症和夜间尿失禁。
