Weiss J P, Blaivas J G, Stember D S, Brooks M M
New York Hospital/Cornell Medical Center, New York, USA.
Neurourol Urodyn. 1998;17(5):467-72. doi: 10.1002/(sici)1520-6777(1998)17:5<467::aid-nau2>3.0.co;2-b.
Nocturia is one of the most bothersome of all urologic symptoms, yet even a rudimentary classification does not exist. We herein propose a classification system of nocturia based on a retrospective study. The records of 200 consecutive patients with nocturia were reviewed. Evaluation included history, micturition diary (including day, night, and 24-hr voided volume), postvoid residual urine (PVR), and videourodynamic study (VUDS). Functional bladder capacity (FBC) was determined to be the largest voided volume in a 24-hr period. The etiology of nocturia was thus classified into one of three groups: nocturnal polyuria ([NP] in which voided urine volume during the hours of sleep exceeds 35% of the 24-hr output), nocturnal detrusor overactivity ([NDO] defined as nocturia attributable to diminished bladder capacity during the hours of sleep), and mixed (NP+NDO); polyuria (24-hr urine output >2,500 cc) was classified separately. There were 129 women and 65 men ranging in age from 17 to 94 years (x=59). Overall 13 (7%) had NP, 111 (57%) NDO, and 70 (36%) had a mixed etiology of their nocturia (both NP and NDO). Forty-five (23%) also had polyuria. These data confirm that the etiology of nocturia is multifactorial and in many instances unrelated to the underlying urologic condition. Nocturnal overproduction of urine is a significant component of nocturia in 43% of patients, most of whom will also have NDO. We believe that treatment should be directed at both conditions.
夜尿症是所有泌尿系统症状中最令人困扰的症状之一，但目前甚至还没有一个基本的分类方法。我们在此基于一项回顾性研究提出一种夜尿症分类系统。对连续200例夜尿症患者的记录进行了回顾。评估内容包括病史、排尿日记（包括白天、夜间及24小时排尿量）、排尿后残余尿量（PVR）以及影像尿动力学研究（VUDS）。功能性膀胱容量（FBC）被确定为24小时内最大排尿量。夜尿症的病因因此被分为三组之一：夜间多尿（[NP]，即睡眠期间排尿量超过24小时总尿量的35%）、夜间逼尿肌过度活动（[NDO]，定义为因睡眠期间膀胱容量减小导致的夜尿症）以及混合型（NP + NDO）；多尿症（24小时尿量>2500 cc）单独分类。有129名女性和65名男性，年龄范围为17至94岁（x = 59）。总体而言，13例（7%）患有NP，111例（57%）患有NDO，70例（36%）夜尿症病因混合型（NP和NDO均有）。45例（23%）还患有多尿症。这些数据证实夜尿症的病因是多因素的，在许多情况下与潜在的泌尿系统疾病无关。43%的患者中，夜间尿液产生过多是夜尿症的一个重要组成部分，其中大多数患者也会有NDO。我们认为治疗应针对这两种情况。
