1.Department of Endocrinology, Jizhong Energy Fengfeng Group Hospital, Hebei Province, Handan 056200, China;
2.Department of Critical Medicine, Jizhong Energy Fengfeng Group Hospital, Hebei Province, Handan 056200, China;
3.Department of Endoscopy, Jizhong Energy Fengfeng Group Hospital, Hebei Province, Handan 056200, China;
4.Department of Operating Room, Jizhong Energy Fengfeng Group Hospital, Hebei Province, Handan 056200, China
Abstract：Objective To explore the methods and possible influencing factors of primary screening of neurogenic bladder in type 2 diabetes mellitus. Methods From January to December 2018, 209 male patients with type 2 diabetes were selected from the Department of Endocrinology of Jizhong Energy Fengfeng Group Hospital. According to different bladder residual urine volume, 125 cases were divided into group A (bladder residual urine volume ＜ 50 mL) and 84 cases were divided into group B (bladder residual urine volume ≥50 mL). Prostate volume, international prostate symptom score (IPSS), random blood glucose, glycosylated hemoglobin, diastolic blood pressure, systolic blood pressure and diabetes course were compared between the two groups; the effect of the above observation indexes on bladder residual urine volume was analyzed by multiple regression analysis; the probability of increased bladder residual urine volume caused by diabetes course and prostate volume was compared between the two groups. Pearson test was used to analyze the correlation between bladder residual urine volume and diabetes course, glycosylated hemoglobin and random blood glucose at admission. Results Compared with group A, group B had longer diabetes course, enlarged prostate volume and high blood glucose at admission (P ＜ 0.05). The score of urination problem in group B was significantly higher than that in group A, and the difference was statistically significant (P ＜ 0.05); the number of patients with residual urine ≥50 mL was significantly increased in patients with diabetes course greater than 10 years and prostate volume greater than 30 mL (P ＜ 0.05); glycosylated hemoglobin, duration of diabetes, and prostate volume were risk factors for increased bladder residual urine volume (P ＜ 0.05); when the prostate volume was less than 30 mL, the amount of residual bladder urine was closely related to the course of diabetes (r = 0.289, P ＜ 0.05); when prostate volume increased (≥30 mL), bladder residual urine volume was closely correlated with glycosylated hemoglobin and random blood glucose upon admission (r = 0.370, 0.381, P ＜ 0.05). Conclusion Bladder residual urine measurement combined with IPSS can assist in early screening of diabetic neurological bladder. The method is simple and easy to use. For patients with diabetes with a long course and enlarged prostate, early intervention and active prevention and treatment are needed.
[1] Galì A，Mucciardi G，Butticè S，et al. Correlation Between Advanced Glycation End-Products，Lower Urinary Tract Symptoms and Bladder Dysfunctions in Patients with type 2 Diabetes Mellitus [J]. Low Urin Tract Symptoms，2017，9（1）：15-20.
[2] 钱荣立.关于糖尿病的新诊断标准与分型[J].中国糖尿病杂志，2000，8（1）：5-6.
[3] Peng X，Li SY，An ZM，et al. Application Value of American Urological Association Symptom Index Score in Female Patients with Type 2 Diabetic Neurogenic Bladder [J]. Sichuan Da Xue Xue Bao Yi Xue Ban，2019，50（4）：566-570.
[4] Majima T，Matsukawa Y，Funahashi Y，et al. Urodynamic analysis of the impact of diabetes mellitus on bladder function [J]. Int J Urol，2019，26（6）：618-622.
[5] Cao N，Gu B，Gotoh D，et al. Time-Dependent Changes of Urethral Function in Diabetes Mellitus：A Review [J]. Int Neurourol，2019，23（2）：91-99.
[6] Karoli R，Bhat S，Fatima J，et al. A study of bladder dysfunction in women with type 2 diabetes mellitus [J]. Indian J Endocrinol Metab，2014，18（4）：552-557.
[7] Wang D，Li Y，Hou G，et al. Pygeum africanum：effect on oxidative stress in early diabetes-induced bladder [J]. Int Urol Nephrol，2010，42（2）：401-408.
[8] Yuan Z，Tang Z，He C，et al. Diabetic cystopathy：A review [J]. Diabetes，2015，7（4）：442-447.
[9] Liu G，Daneshgar F. Diabetic Bladder Dysfunction [J]. Chin Med，2014，127（7）：1357-1364.
[10] 曹迎东，李翠凡，夏武宪，等.糖尿病神经性膀胱患者血浆同型半胱氨酸、血清叶酸、维生素B12的水平及尿动力学变化分析[J].中国糖尿病杂志，2018，26（7）：563-565.
[11] 双卫兵，仝煦楠.糖尿病膀胱研究进展[J].临床外科杂志，2016，24（2）：95-97.
[12] Capon G，Caremel R，de Sèze M，et al. The impact of mellitus diabetes on the lower urinary tract：A review of Neuro-urology Committee of the French Association of Urolog [J]. Prog Urol，2016，26（4）：245-253.
[13] 刘芳，杨小荣，刘焕兵，等.老年良性前列腺增生合并糖尿病患者的尿流动力学检测[J].中国老年学杂志，2016， 36（2）：342-343.
[14] Lien WC，Kuan TS，Lin YC，et al. Patients With Neurogenic Lower Urinary Tract Dysfunction Following Spinal Cord Injury Are at Increased Risk of Developing Type 2 Diabetes Mellitus：A Population-Based Cohort Study [J]. Medicine，2016，95（2）：e2518.
[15] 刘波，高伟，刘锐，等.膀胱残余尿量水平监测及2型糖尿病患者排尿习惯的临床分析[J].中国实验诊断学，2008， 12（1）：105-107.
[16] Kim MJ，Park JS，Lim HJ，et al. Emphysematous Pyelonephritis Caused by Citrobacter freundii in a Patient with Type 2 Diabetes and Neurogenic Bladder [J]. Infect Chemother，2013，45（3）：331-334.
[17] Tam CA，Helfand BT，Erickson BA. The Relationship Between Diabetes，Diabetes Severity，Diabetes Biomarkers，and the Presence of Lower Urinary Tract Symptoms：Findings From the National Health and Nutrition Examination Survey [J]. Urology，2017，105：141-148.
[18] 李兴杰，王引弟，童明辉.良性前列腺增生症患者前列腺体积、前列腺特异抗原、残余尿各因素之间的关系研究[J].临床实践，2012，30（12）：139-140.
[19] 金毅，胡忠良，吕丽飞，等.良性前列腺增生（BPH）合并糖尿病患者的尿动力变化特点与临床分析[J].中国医药导刊，2017，19（6）：553-554.
[20] Changxiao H，Zhengyong Y，Shibing Y，et al. Clinical and urodynamic evaluation of women referred with diabetes mellitus [J]. Int Urogynecol，2014，25（7）：979-983.
[21] 刘亚东，卫中庆，张思聪，等.糖尿病膀胱的研究进展[J].临床泌尿外科杂志，2018，33（7）：582-585.
2020, Vol. 17 
京公网安备 11010502046598号