脑小血管病排尿与排便障碍研究现状及机制探索

Research Status and Mechanism of Bowel and Bladder Dysfunction in Cerebral Small Vessel Disease

脑小血管病(cerebral small vessel disease,CSVD)是一种主要累及脑内小血管的慢性全脑性疾病,临床表现多样。排尿障碍和排便障碍作为CSVD的常见症状,严重影响着人们的日常生活和社会功能。约70%的CSVD患者可出现排尿障碍,以排尿刺激症状为主,可表现为尿频、尿急、急迫性尿失禁及夜尿增多,且与疾病的严重程度、病变部位相关。排便障碍与脑血管病关系密切,但目前尚无有关CSVD患者排便障碍的大型流行病学数据。本文分别以CSVD患者排尿功能障碍与排便功能障碍为切入点,探讨CSVD患者二便障碍的发生率和具体表现形式,探索可能引起CSVD患者二便障碍的病理生理机制,为CSVD的诊治提供新的方向。

Cerebral small vessel disease(CSVD) is a major chronic whole-brain disease mainly involving small vessels in the brain, with diverse clinical manifestation. CSVD has attracted more and more attention in recent years. As common clinical manifestation of CSVD, bowel and bladder dysfunction(BBD) seriously affect patients’ daily life and social function. Urinary dysfunction may occur in about 70% of CSVD patients, which mainly be manifested as urinary stimulation symptoms including urinary frequency, urgency, incontinence and nocturia, and the clinical symptoms are related with the severity of CSVD and lesions location. Bowel dysfunction is closely related to cerebral vascular diseases, but there is no large-scale epidemiological data on bowel disorders in patients with CSVD. This paper discussed the incidence and clinical manifestation of BBD, the possible pathogenesis of BBD in patients with CSVD, to provide a new direction for the diagnosis and treatment of CSVD.