The Clinical Study On Influencing Factors Of Lower Urinary Tract Dysfunction In Parkinson's Disease

Objective:Lower urinary tract dysfunction(LUT dysfunction)is a common nonmotor symptom of Parkinson's disease(PD),which severely affects the patient's quality of life.The objective of our research is to explore the occurrence of lower urinary tract symptom(LUT symptom)and its related influencing factors in PD patients,so as to guide the clinical diagnosis,evaluation and treatment.Methods:This study enrolled 100 PD patients who visited the Department of Neurology at Shengjing Hospital of China Medical University from May,2017 to March,2018.We recorded the general information of patients including gender,age,age of onset,disease duration,PD subtype,dosage of anti-PD drugs,the presence of hyposmia and other nonmotor symptoms,years of education.Motor disability and disease severity were rated using the Hoehn-Yahr stage(H-Y stage)and Movement Disorder Society Unified Parkinson's Disease Rating Scale III(MDS-UPDRSIII),respectively.Global cognitive function was assessed by the Mini-Mental Status Examination(MMSE),Montreal Cognitive Assessment(MoCA),and Frontal Assessment Battery(FAB).The patient's LUT symptom was evaluated using the overactive bladder symptom score(OABSS).The patients were classified based on their OABSSs and then assigned to either a PD with overactive bladder(PD-OAB)group or a PD with no overactive bladder(PD-NOAB)group.Any symptom with a score?1 is considered to be due to LUT dysfunction.SPSS17.0 was used to analyze data,logistic regression analysis was performed to identify the accompanying factors for overactive bladder(OAB)and multiple linear regression analysis was performed to explore the related factors influencing the severity of LUT dysfunction.Results:1.Eighty-nine(89%)of the PD patients suffered from LUT dysfunction,and OAB was diagnosed in 45(45%)of PD patients.The most common LUT symptom in the PD patients was nighttime frequency(86%),followed by urgency(50%),urge incontinence(34%),and daytime frequency(17%).2.There were 45 PD patients with OAB(29 males and 16 females),55 PD patients without OAB(26 males and 29females).The values for patient's age,age of onset,Hoehn-Yahr stage,MDS-UPDRSIII score,and RBD in the PD-OAB group were significantly higher than those in the PD-NOAB group(P<0.05).Moreover,the MoCA and FAB scores in the PD-OAB group were significantly lower than those in the PD-NOAB group(P<0.05).Logistic regression analysis showed that the FAB score,Hoehn-Yahr stage and RBD entered the regression equation,and the OR values(95%confidence interval)were 3.344(1.842-6.074),3.007(1.373-6.585)and 3.414(1.196-9.745),respectively.3.Multiple linear regression analysis showed that FAB score,Hoehn-Yahr stage,RBD and age entered the regression equation(R~2=0.428;FAB score,P<0.001;H-Y stage,P=0.028;RBD,P=0.012;age,P=0.004).Conclusion:1.Low FAB score,high Hoehn-Yahr stage and RBD are accompanying factors for OAB.2.A higher OABSS in PD patients was related to a lower FAB score,a higher Hoehn-Yahr stage,RBD,and an older age.The higher the total OABSS score is,the more severe the LUT dysfunction becomes.