中老年2型糖尿病女性患者病程与膀胱功能障碍的相关性研究

目的 研究中老年2型糖尿病女性患者的病程与膀胱功能障碍的相关性。方法 选取本院2017年1月至2018年9月门诊年龄≥40岁的女性2型糖尿病患者217例作为研究对象，根据病程分为<10年和≥10年两组，其中<10年组126例，≥10年组91例。患者均行尿动力学检查，比较两组患者初感尿意量异常、逼尿肌收缩力异常、残余尿量增加、逼尿肌无抑制性收缩、逼尿肌与括约肌收缩不协调发生率；采用膀胱过度活动症症状评分(OABSS)量表调查两组患者膀胱过度活动症状及严重程度。再以病程为自变量，膀胱过度活动症状严重程度及差异有统计学意义的尿动力学检查指标为因变量，采用多因素非条件logistic回归分析与病程的相关性。结果 病程≥10年组患者尿动力检查初感尿意量异常、逼尿肌收缩力异常、逼尿肌无抑制性收缩发生率明显高于<10年组，差异有统计学意义（P<0.05）。两组残余尿量增加、逼尿肌与括约肌收缩不协调发生率比较差异无统计学意义(P>0.05)。病程≥10年组有膀胱过度活动症状者占51.65%，明显高于<10年组的2302%，且病程≥10年组中、重度患者的构成比例明显高于<10年组，差异有统计学意义（P<0.05）。多因素logistic回归分析显示，病程与膀胱过度活动症状、初感尿意量异常、逼尿肌收缩力异常相关。结论 老年2型糖尿病女性患者的病程与膀胱过度活动症状及严重程度、尿动力学检查异常率密切相关，提示临床对于病程长的患者应重视对膀胱功能障碍的诊断。

Correlation between the course of disease and bladder dysfunction in middle-aged and elderly women with type 2 diabetes mellitus

Objective To study the correlation between the course of disease and bladder dysfunction in middle-aged and elderly women with type 2 diabetes mellitus.Methods From January 2017 to September 2018,217 outpatient service age of 40 or more female patients with type 2 diabetes were selected as the research object,according to the course,all patients were divided into<10 years group(n=126)and group of 10 years or more(n=91).All patients underwent urine dynamics test,and early abnormal amount of sense to urinate,abnormal detrusor contraction force,residual urine volume increased,detrusor without inhibitory and detrusor sphincter contraction uncoordinated incidence of two groups were compared.Symptoms and severity of bladder hyperactivity were investigated by OABSS scale.Then,the course of the disease was taken as the independent variable,and the severity of symptoms of bladder hyperactivity and the indicators of urodynamics with statistical significance were taken as dependent variables.The correlation between the severity of the symptoms and the course of the disease was analyzed by multifactor unconditioned logistic regression.Results The incidence of the patients with the duration of the disease greater than or greater than 10 years in the group with abnormal initial urinary intention,abnormal detrusor contractility,and non-inhibitory detrusor contractility was 65.93%,82.42%,and 79.12%,respectively,which were significantly higher than the rates of 40.48%,49.21%,and 36.51%in the<10 years group,with statistically significant differences(P<0.05).There was no statistically significant difference between the two groups in the incidence of residual urine volume increase and incongruity between detrusor and sphincter contraction(P>0.05).The proportion of patients with symptoms of bladder hyperactivity in the group with a course greater than 10 years was 51.65%,significantly higher than 23.02%in the group with a course greater than 10 years,and the proportion of patients with moderate or severe disease greater than 10 years was significantly higher than that in the group with a course greater than 10 years,with statistically significant difference(P<0.05).Multivariate logistic regression analysis showed that the course of the disease was associated with symptoms of bladder hyperactivity,abnormal initial urinary sense,and abnormal detrusor contractility.Conclusions The course of disease in elderly women with type 2 diabetes mellitus is closely related to the symptoms and severity of bladder hyperactivity and abnormal rate of urodynamic examination,suggesting that the diagnosis of bladder dysfunction should be emphasized in patients with long course of disease.