Tateno Fuyuki, Sakakibara Ryuji, Aiba Yosuke
Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.
Neurology, Chiba University, Chiba, Japan.
Case Rep Neurol. 2021 Jul 20;13(2):490-498. doi: 10.1159/000514825. eCollection 2021 May-Aug.
It remains uncertain to what extent lower urinary tract (LUT) symptom (LUTS) is a comorbidity of myasthenia gravis (MG). We prospectively administered a LUTS questionnaire devised for detecting neurogenic pelvic organ dysfunction (not validated) in an MG group and a healthy control group and compared the results. The MG group comprised 21 patients: 15 women and 6 men, with age range 22-73 (mean 47) years, illness duration range 0.2-8 (mean 3.5) years, median Myasthenia Gravis Foundation of America (MGFA) grade 2, all walking independently. Therapies included thymectomy in 17, predonisolone 5-20 mg/day in 10, and pyridostigmine bromide 60-180 mg/day in 9 patients. The control group, who were undergoing an annual health survey, comprised 235 consecutive subjects: 120 women and 115 men, with age range 30-69 (mean 48) years. The questionnaire had 9 questions. Each question was scored from 0 (none) to 3 (severe) with an additional quality of life (QOL) index scored from 0 (satisfied) to 3 (extremely dissatisfied). Statistical analysis was made using Student's test. Compared with the control subjects, the frequency of LUTSs in the MG patients was significantly higher for daytime frequency (43%; < 0.01), nocturia (24%; < 0.01), and urinary incontinence (43%; < 0.05). The LUTS-related QOL index for the MG patients was significantly higher for MG patients as a whole than that for all control patients (29%) ( < 0.05). In conclusion, our study results showed that MG patients had significantly more LUTSs (overactive bladder) than healthy control subjects and had worse LUTS-related QOL; therefore, amelioration of LUTS in MG is important.
下尿路（LUT）症状（LUTS）在多大程度上是重症肌无力（MG）的一种合并症仍不确定。我们前瞻性地在MG组和健康对照组中使用了一份为检测神经源性盆腔器官功能障碍而设计的LUTS问卷（未经验证），并比较了结果。MG组包括21例患者：15名女性和6名男性，年龄范围为22 - 73岁（平均47岁），病程范围为0.2 - 8年（平均3.5年），美国重症肌无力基金会（MGFA）分级中位数为2级，均能独立行走。治疗方法包括17例行胸腺切除术，10例每天服用5 - 20毫克泼尼松龙，9例每天服用60 - 180毫克溴吡斯的明。对照组为正在接受年度健康检查的连续235名受试者：120名女性和115名男性，年龄范围为30 - 69岁（平均48岁）。问卷有9个问题。每个问题从0分（无）到3分（严重）评分，另有一个生活质量（QOL）指数从0分（满意）到3分（极其不满意）评分。使用学生t检验进行统计分析。与对照组相比，MG患者中LUTSs的日间排尿频率（43%；P < 0.01）、夜尿症（24%；P < 0.01）和尿失禁（43%；P < 0.05）的发生率显著更高。MG患者整体的LUTS相关QOL指数显著高于所有对照组患者（29%）（P < 0.05）。总之，我们的研究结果表明，MG患者的LUTSs（膀胱过度活动症）明显多于健康对照组，且LUTS相关QOL更差；因此，改善MG患者的LUTS很重要。
