CAJ | 학술논문

目的研究早期糖尿病性膀胱病(DCP)的无创尿动力学指标变化,为其早期诊断提供依据.方法以糖尿病病程1年为限将85例2型糖尿病患者分为初诊糖尿病组(32例)和非初诊糖尿病组(53例),以30例非糖尿病者作为对照组,分别应用无创尿动力学方法进行最大尿流率、平均尿流率、初尿意膀胱容量及残尿量测定.结果初诊糖尿病组中有残余尿者18例,残尿量(13.2±17.3)ml,最大尿流率(18.4±6.9)ml/s,平均尿流率(10.6±5.3)ml/s,DCP检出率56.2%(18/32).非初诊糖尿病组中有残余尿者38例,残尿量(19.3±18.4)ml,最大尿流率(14.7±6.6)ml/s,平均尿流率(9.5±4.7)ml/s,DCP检出率71.7%(38/53).对照组无残余尿,最大尿流率(25.7±5.9)ml/s,平均尿流率(18.0±4.9)ml/s.初诊糖尿病组及非初诊糖尿病组最大尿流率、平均尿流率均低于对照组(P<0.01),残尿量高于对照组(P<0.01).非初诊糖尿病组最大尿流率明显低于初诊糖尿病组(P<0.05).结论糖尿病早期便可出现尿动力学改变,其中可能以最大尿流率降低为最敏感指标.应用新的无创尿动力学检测方法可早期诊断DCP并动态观察评价膀胱功能.
목적 연구조기당뇨병성방광병(DCP)적무창뇨동역학지표변화,위기조기진단제공의거.방법 이당뇨병병정1년위한장85례2형당뇨병환자분위초진당뇨병조(32례)화비초진당뇨병조(53례),이30례비당뇨병자작위대조조,분별응용무창뇨동역학방법진행최대뇨류솔、평균뇨류솔、초뇨의방광용량급잔뇨량측정.결과 초진당뇨병조중유잔여뇨자18례,잔뇨량(13.2±17.3)ml,최대뇨류솔(18.4±6.9)ml/s,평균뇨류솔(10.6±5.3)ml/s,DCP검출솔56.2%(18/32).비초진당뇨병조중유잔여뇨자38례,잔뇨량(19.3±18.4)ml,최대뇨류솔(14.7±6.6)ml/s,평균뇨류솔(9.5±4.7)ml/s,DCP검출솔71.7%(38/53).대조조무잔여뇨,최대뇨류솔(25.7±5.9)ml/s,평균뇨류솔(18.0±4.9)ml/s.초진당뇨병조급비초진당뇨병조최대뇨류솔、평균뇨류솔균저우대조조(P<0.01),잔뇨량고우대조조(P<0.01).비초진당뇨병조최대뇨류솔명현저우초진당뇨병조(P<0.05).결론 당뇨병조기편가출현뇨동역학개변,기중가능이최대뇨류솔강저위최민감지표.응용신적무창뇨동역학검측방법가조기진단DCP병동태관찰평개방광공능.
Objective To study the abnormalities of noninvasive urodynamios in early diabetes eystopathy (DCP) and provide diagnosis evidences in its early stage. Methods According to the disease course (less or more than 1 year), 85 patients with type 2 diabetes mellitus (T2DM) were divided into new lydiagnosed diabetic group and non-newly diagnosed diabetic group. Thirty healthy cases were involved in normal control group. All of them were checked with the technology of noninvasive urodynamics to measure maximal flow rate, average flow rate, the volume leading to first bladder sensation and residual urine volume. Results As to the 32 newly diagnosed diabetic group, maximal flow rate was (18.4±6.9) ml/s, and average flow rate was (10.6 ± 5.3) ml/s, 18 cases were detected to have bladder residual urine, with the average residual urine volume of (13.2 ± 17.3) ml, and the DCP detection rate was 56.2%(18/32). As to the 53 non-newly diagnosed diabetic group, maximal flow rate was (14.7 ± 6.6) ml/s, and average flow rate was (9.5±4.7) ml/s,38 cases were detected to have bladder residual urine, with the average residual urine volume of (19.3 ± 18.4) ml, and the DCP detection rate was 71.7%(38/53). There was no residual urine detected in normal control group. Their maximal flow rate was (25.7 ± 5.9) ml/s, and average flow rate was (18.0 ± 4.9)ml/s. Compared with that in normal control group, maximal flow rate, average flow rote and residual urine volume decreased in both newly diagnosed diabetic group and non-newly diagnosed diabetic group(P< 0.01). As compared with that in newly diagnosed diabetic group, maximal flow rate in non-newly diagnosed diabetic group decreased obviously (P< 0.05). Conclusions The abnormalities of urodynamics may happen in the early stage of diabetes, and maximal flow rate may be as the most sensitive index. With the new technology of noninvasive urodynamies, we DCP can be diagnosed in early stage and evaluated the function of bladder dynamically.