Ellenberg M
Ann Intern Med. 1980 Feb;92(2 Pt 2):321-3. doi: 10.7326/0003-4819-92-2-321.
The diabetic neurogenic paralytic bladder is characterized by marked residual urine, secondary infection, pyelonephritis, sepsis, and azotemia. Initial manifestations were studied in diabetic patients with and without neuropathy and in nondiabetic controls, all without symptoms referable to the urinary tract. The nondiabetic controls and the diabetics without neuropathy were urologically normal. Eighty-three percent of the diabetic patients with neuropathy had objective evidence of neurogenic bladder involvement; however, there was no residual urine, infection, pyelonephritis, sepsis or azotemia. The disparity between early and late bladder involvement is determined by the factor of residual urine, which is the measure of advancing bladder neuropathy leading to decompensation. Progressive decompensation of the asymptomatic diabetic bladder may be a cause of the increased frequency of renal infection in diabetic patients.
糖尿病神经源性麻痹性膀胱的特征为明显的残余尿、继发感染、肾盂肾炎、败血症和氮质血症。对患有和未患神经病变的糖尿病患者以及无泌尿系统相关症状的非糖尿病对照者的初始表现进行了研究。非糖尿病对照者和无神经病变的糖尿病患者泌尿系统正常。83%患有神经病变的糖尿病患者有神经源性膀胱受累的客观证据；然而，并无残余尿、感染、肾盂肾炎、败血症或氮质血症。早期和晚期膀胱受累情况的差异由残余尿这一因素决定，残余尿是膀胱神经病变进展导致失代偿的一个指标。无症状糖尿病膀胱的进行性失代偿可能是糖尿病患者肾脏感染频率增加的一个原因。
