Chen J, Ren Y, Zhu L
Department of Obstetrics & Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2020 Oct 13;100(37):2908-2912. doi: 10.3760/cma.j.cn112137-20200301-00525.
To investigate the characteristics of modified Oxford grading scale (MOS) and pelvic floor surface electromyography (sEMG) based on Glazer protocol in patients with stress urinary incontinence (SUI), and analyze the correlation between the two methods. This study was a cross-sectional survey. A total of 212 subjects in May 2019 were enrolled and divided into SUI group (=61) and non-SUI group (=151) based on the commonly used 3 incontinence questions (3IQ). MOS test and sEMG parameters were measured by the same rehabilitator. The sEMG parameters included the mean and variation coefficient in the prerest phase, the maximum and relaxation time of 5 rapid contractions, the mean and variability of EMG in 10 s tonic contraction phase, the mean and variability of EMG in 60 s endurance contraction phase, and the mean and variability of EMG in postrest phase. The differences of the above parameters between SUI group and non-SUI group were compared, the logistic regression and Spearman method were used to analyze the correlation between MOS and sEMG parameters. The prevalence of SUI was 28.8%(61/212) in community, body mass index and delivery mode were the risk factors (all <0.05). The MOS of the SUI group and the non-SUI group were 3 (2,3) and 3 (3,4), respectively, with significant difference (=-2.58, =0.010). Among the sEMG parameters of SUI group and non-SUI group, the maximum values of phasic contractions were 23.12 (13.65, 37.89), 30.68 (20.28, 47.02) μV, the mean of tonic contractions were 14.32 (9.62, 21.49), 17.65 (12.05, 26.35) μV, and the mean of endurance contractions were 12.78(7.88, 18.76), 16.55(11.13, 22.40) μV, respectively, with statistical significance (=-2.34, -2.37, -3.20, all <0.05). The multivariate logistic regression revealed that both the variation coefficient of tonic contractions (=157.86, 95%: 1.99-12 595.51, <0.05) and the amplitude of endurance contractions(=1.11, 95%: 1.03-1.19, <0.05) were correlated with SUI. The tonic contractions amplitude had the tendency to be related to SUI (=0.95, 95%: 0.09-1.00, <0.05). In all subjects, MOS was correlated with the maximum value of rapid contractions, average value of tonic contractions and average value of endurance contractions (=0.516, 0.503, 0.464, all <0.05). In SUI group (=0.510, 0.442, 0.385, all <0.05), and non-SUI group (=0.495, 0.524, 0.488, all <0.05), MOS was correlated with the above parameters. MOS and sEMG based on Glazer protocol indicate that the contractility of pelvic floor muscle decreases in SUI patients. The results of sEMG and MOS are consistent, which can be used for quantitative evaluation of pelvic floor muscle function in SUI patients.
探讨改良牛津分级量表(MOS)及基于Glazer方案的盆底表面肌电图(sEMG)在压力性尿失禁(SUI)患者中的特点,并分析两种方法之间的相关性。本研究为横断面调查。2019年5月共纳入212名受试者,根据常用的3个尿失禁问题(3IQ)分为SUI组(=61)和非SUI组(=151)。MOS测试和sEMG参数由同一名康复治疗师测量。sEMG参数包括静息前期的平均值和变异系数、5次快速收缩的最大值和松弛时间、10s强直收缩期EMG的平均值和变异性、60s耐力收缩期EMG的平均值和变异性以及静息后期EMG的平均值和变异性。比较SUI组和非SUI组上述参数的差异,采用逻辑回归和Spearman法分析MOS与sEMG参数之间的相关性。社区中SUI的患病率为28.8%(61/212),体重指数和分娩方式为危险因素(均<0.05)。SUI组和非SUI组的MOS分别为3(2,3)和3(3,4),差异有统计学意义(=-2.58,=0.010)。SUI组和非SUI组的sEMG参数中,相位收缩的最大值分别为23.12(13.65,37.89)、30.68(20.28,47.02)μV,强直收缩的平均值分别为14.32(9.62,21.49)、17.65(12.05,26.35)μV,耐力收缩的平均值分别为12.78(7.88,18.76)、16.55(11.13,22.40)μV,差异有统计学意义(=-2.34,-2.37,-3.20,均<0.05)。多因素逻辑回归显示,强直收缩的变异系数(=157.86,95%:1.99-12595.51,<0.05)和耐力收缩的幅度(=1.11,95%:1.03-1.19,<0.05)均与SUI相关。强直收缩幅度有与SUI相关的趋势(=0.95,95%:0.09-1.00,<0.05)。在所有受试者中,MOS与快速收缩的最大值、强直收缩的平均值和耐力收缩的平均值相关(=0.516,0.503,0.464,均<0.05)。在SUI组(=0.510,0.442,0.385,均<0.05)和非SUI组(=0.495,0.524,0.488,均<0.05)中,MOS与上述参数相关。基于Glazer方案的MOS和sEMG表明SUI患者盆底肌肉的收缩力下降。sEMG和MOS的结果一致,可用于定量评估SUI患者的盆底肌肉功能。