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评价儿童和青少年膀胱过度活动症的自主神经功能。

Evaluation of autonomic function in children and adolescents with overactive bladder.

机构信息

Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil.

Department of Urology, Yale School of Medicine, New Haven, CT, United States.

出版信息

Int Braz J Urol. 2021 Nov-Dec;47(6):1178-1188. doi: 10.1590/S1677-5538.IBJU.2021.0177.

Abstract

AIMS

To evaluate autonomic activity in children/adolescents with isolated overactive bladder.

MATERIALS AND METHODS

Descriptive, analytical, non-interventional, cross-sectional study conducted between February 2017 and January 2018 with individuals aged between 5 and 17 years old, with overactive bladder (OAB group) or asymptomatic (control). Neurological or anatomical abnormalities, diabetes mellitus and kidney failure constituted exclusion criteria. The DVSS and the Rome III questionnaire were applied, and heart rate variability (HRV) was assessed. The chi-square test, Student's t-test, ANOVA and the Mann Whitney U test were used in the statistical analysis.

RESULTS

41 patients with OAB and 20 controls were included. In the OAB group, there were more girls (p=0.23), more overweight/obese and constipated patients. The DVSS score was higher in the OAB group. HRV showed a higher heart rate variability at the frequency domain and LF/HF variation in the control group (p=0.02 and p=0.05 respectively). In the intergroup evaluation, LF (Hz) was predominant in the control group at the post-voiding evaluation moment (p=0.03).

CONCLUSION

The control group demonstrated a physiological heart rate variation during the voiding process, with a predominance of sympathetic activity during urinary storage.

摘要

目的

评估孤立性过度活动膀胱患儿/青少年的自主神经活动。

材料和方法

这是一项描述性、分析性、非干预性、横断面研究,于 2017 年 2 月至 2018 年 1 月进行,研究对象为年龄在 5 至 17 岁之间的个体,分为过度活动膀胱(OAB 组)或无症状(对照组)。有神经或解剖学异常、糖尿病和肾衰竭的患者被排除在外。应用了膀胱过度活动症严重程度评分(DVSS)和罗马 III 问卷,并评估了心率变异性(HRV)。统计分析中使用了卡方检验、学生 t 检验、方差分析和曼-惠特尼 U 检验。

结果

共纳入 41 例 OAB 患者和 20 例对照组。在 OAB 组中,女孩更多(p=0.23),超重/肥胖和便秘患者更多。OAB 组的 DVSS 评分更高。HRV 显示对照组在频域和 LF/HF 变化方面的心率变异性更高(p=0.02 和 p=0.05 分别)。在组间评估中,对照组在排尿后评估时刻的 LF(Hz)更为突出(p=0.03)。

结论

对照组在排尿过程中表现出生理性心率变化,在储尿期以交感神经活动为主导。

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