排尿日记在60岁以上前列腺增生症患者夜尿原因分析中的作用

Urinary diary in evaluation of nocturia in benign prostatic hyperplasia patients over 60 years old

目的分析老年前列腺增生症患者夜尿次数增多的原因以及排尿日记对其作用。方法72例60岁以上前列腺增生症患者记录排尿日记、国际前列腺症状评分（IPSS）、生存质量评分，并测量前列腺体积及最大尿流率，进行尿动力学检查。将结果与患者的夜尿次数进行比较。结果4例（7％）全天尿量在2500ml以上。23例（40％）夜间尿量〉全天尿量的33％。夜尿次数增多组（14例）夜尿量及残余尿量相对于夜尿次数正常组（58例）显著增多；而单次最大尿量显著减少，差异有统计学意义（P〈0．01）。而两组年龄、前列腺体积、最大尿流率及IPSS评分差异无统计学意义。58例夜尿次数增多者尿动力学检查显示35例（60％）有不稳定膀胱，其中24例（69％）夜问平均每次尿量〈100ml。结论患者的夜尿量以及膀胱功能是影响患者夜尿次数的决定因素，而详细的排尿日记对于决定患者的治疗方案非常有益。

Objective To evaluate the causes of nocturia in the elderly patients with benign prostatic hyperplasia （BPH） and significance of urinary diary on it. Methods Seventy-two patients with BPH aged over 60 years who keep urinary diaries were recruited in the study and undergone with international prostatic symptom score （IPSS） and quality of life score evaluation and measurements of prostate volume and peak urinary flow rate. Correlation between frequency of nocturia and the measurements mentioned-above was analyzed. Results Whole-day urinary volume amounted more than 2500 ml in four patients （7%）, and nocturnal urinary volume accounted for more than 33% of their daytime urinary volume in 23 patients （40%）. Nocturnal urinary volume and residual urinary volume were significantly more in 14 patients with increased urinary frequency than in 58 patients with normal frequency, but volume of each urination was significantly decreased in the formers than that in the latter, P 〈0.01. There was no significant difference in age, prostate volume, peak urinary flow rate and IPSS score between those with increased and normal urinary frequencies. Urinary dynamic examinations showed that 35 （60%） of 58 patients with increased nocturnal urinary frequency had unstable urinary bladders, with an average nocturnal volume of each urination of less than 100 ml in 24 of them. Conclusions Nocturnal urinary volume and bladder function were determinant factors which affect their nocturnal urinary frequency. Three factors, i. e. , IPSS score, prostate volume and peak urinary flow rate, correlate with BPH, but not with nocturia. Keeping a detailed urinary diary for the patients is beneficial for elucidating their urinary function and in decision-making of their treatment regimen.