老年良性前列腺增生夜尿病因分类和相关因素分析

Etiological classification and risk factors analysis of nocturia in patients with benign prostatic hyperplasia

目的 探讨老年良性前列腺增生（BPH）患者夜尿的病因分类以及相关因素. 方法 选取60岁及以上明确诊断为BPH的男性患者,但未对BPH进行治疗或曾经服用药物但停药至少3个月以上者120例,按国际前列腺症状评分（IPSS）中夜尿次数从0～5分为6组,记录研究对象的一般情况和病史、前列腺和膀胱功能的指标和72 h排尿日记并进行分析. 结果 夜尿95例,发病率为79.2%,其中夜尿量增多和膀胱过度活动发病率分别为3.3%和10.8%.夜尿次数尤其是夜间第1次排尿时间过短对生活质量评分有影响.去除夜尿量增多和膀胱过度活动后的多因素分析结果显示,患者的年龄和残余尿量与夜尿次数呈正相关,与夜间膀胱容量呈负相关;前列腺体积和最大尿流率与夜尿次数无关.全天饮水量的增加造成夜尿次数的增多（P＜0.01）. 结论 夜尿在老年BPH患者中很普遍,夜尿次数增多或夜间第1次排尿时间的缩短明显影响老年人的生活质量.排尿日记比IPSS更能反映夜尿的真实情况,可以为分类治疗提供依据.相对于前列腺腺体增生,年龄和夜间膀胱储尿功能对老年人夜尿次数的影响更大.

Objective To explore the classification and risk factors of nocturia in patients with benign prostatic hyperplasia （BPH）. Methods The 120 males aged 60 years old and over were enrolled who were first diagnosed as BPH or had ceased the BPH medication for at least 3 months.The patients were divided into six groups according to the nocturnal voiding episodes estimated according to the international prostate symptom score （IPSS）. All 120 males were inquired about general information and medical histories. The time and volume of intake and voided urine were recorded for 72 hours. The indexes of prostate and bladder function in all cases were also examined and recorded. Results The incidence of nocturia in our study was 79.2%, the incidence of nocturnal polyuria and overactive bladder were 3.3% and 10.8%, respectively. The quality of life was affected by the duration between the time of patients＇ going to bed and the first time getting up at night. After excluding the cases of nocturnal polyuria and overactive bladder, statistical analysis indicated that the age, and residual urine volume of the bladder were positively associated with nocturia frequencies （NF）, the nocturnal voiding volume negatively with NF, while the prostate volume and peak flow rate were not associated with NF. Drinking volume in 24-hours affected the nocturia （P〈0. 01）. Conclusions Nocturia is a common complaint in elderly males with BPH and significantly affects the quality of life. The age and the storing function of bladder are more important factors as compared with prostate hyperplasia itself.