BCR技术在糖尿病性神经源性膀胱诊断及药物疗效评估中的应用价值

The applied value of the BCR technique in diagnosis for diabetic neurogenic bladder and in the evaluation of the efficacy of drugs

目的:探讨球海绵体肌反射(BCR)技术对糖尿病性神经源性膀胱(DNB)的诊断价值,以及对甲钴胺片剂治疗DNB的疗效评估价值。方法:对温州医科大学附属第一医院2009年6月-2012年12月门诊及住院的糖尿病伴有括约肌功能障碍(包括尿潴留或尿失禁)的95例患者(病例组)行BCR检测,并与80例正常对照组(对照组)进行比较。病例组给予口服甲钴胺片剂治疗,3个月后进行临床症状、膀胱残余尿量、血糖检查及BCR再评估。结果:病例组BCR潜伏期延长、波幅下降,与对照组比较差异有统计学意义(P<0.05);对口服甲钴胺片剂治疗3个月的患者进行BCR再评估,结果显示治疗前后BCR潜伏期、波幅差异无统计学意义(P>0.05)。结论:DNB患者存在阴部周围神经损害,BCR检测技术可对其进行定位、定性诊断;DNB病理改变以轴索病变为主,其恢复缓慢或具不可逆性。

Objective： To explore the diagnostic value of bulbocavernosus reflex （BCR） in diabetic neuro-genic bladder. Methods： Neuroelectrophysiological technique was adopted to determine BCR in 95 diabetes patients with or without sphincter dysfunction （Case Group） and 80 healthy adult （Control Group）. All the cases took methylcobalamin tablets for 3 months, then reassed the clinical symptoms, residual urine, blood sugar checks and BCR. Results： BCR latencies in case group were remarkably prolonged than that in control group （P〈0.05）. BCR amplitudes in case group were remarkably decreased than that in control group （P〈0.05）. There is no statistical difference of BCR latencies and amplitudes between the two groups before and after methylcobalamin treatment （P〉0.05）. Conclusion： The patients with diabetic neurogenic bladder have puden- dal nerve diseases. BCR is valuable in the topical diagnosis of patients with diabetic neurogenic bladder. Diabetic neurogenic bladder pathological changes are mainly in axonal lesions. The recovery is slow or irrevers- ible after drug treatment.