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中华脑血管病杂志(电子版) ›› 2024, Vol. 18 ›› Issue (06) : 606 -610. doi: 10.11817/j.issn.1673-9248.2024.06.013

综述

脑小血管病排尿障碍研究进展及机制探讨
王育伟1, 杨琼2, 丁文华3, 邱景景1, 耿玉荣1,()   
  1. 1.832000 新疆石河子,石河子大学第一附属医院神经内科
    2.100191 北京大学第三医院神经内科
    3.710086 西安,陕西省中医药大学第二附属医院脑病科
  • 收稿日期:2024-06-21 出版日期:2024-12-01
  • 通信作者: 耿玉荣
  • 基金资助:
    国家自然科学基金项目(81901204)2022年度兵团指导性科技计划项目(2022ZD029)2020年度石河子大学创新发展专项项目(自然科学类)(CXFZ202002)

Research progress on mechanism of urinary dysfunction in cerebral small-vessel disease

Yuwei Wang1, Qiong Yang2, Wenhua Ding3, Jingjing Qiu1, Yurong Geng1,()   

  1. 1.Department of Neurology, the First Affiliated Hospital of Shihezi University, Shihezi 832000, China
    2.Department of Neurology, Peking University Third Hospital, Beijing 100191, China
    3.Department of Brain Diseases, Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xi'an 710086, China
  • Received:2024-06-21 Published:2024-12-01
  • Corresponding author: Yurong Geng
引用本文:

王育伟, 杨琼, 丁文华, 邱景景, 耿玉荣. 脑小血管病排尿障碍研究进展及机制探讨[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(06): 606-610.

Yuwei Wang, Qiong Yang, Wenhua Ding, Jingjing Qiu, Yurong Geng. Research progress on mechanism of urinary dysfunction in cerebral small-vessel disease[J/OL]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(06): 606-610.

以往研究认为膀胱功能高度依赖中枢神经系统,“血管-脑-膀胱轴”概念已广泛应用于神经系统疾病相关排尿障碍。脑小血管病(CSVD)是老年人不可忽视的疾病负担,排尿障碍是其主要的非认知运动症状,主要有尿频、尿急、夜尿症以及急迫性尿失禁等多样性表现。关于CSVD相关排尿障碍的具体机制尚不完全明确,近来研究发现评估自主神经功能的心率变异性与CSVD 相关排尿障碍有着较强关联,并且多项研究表明传统影像学特征亦与之相关。本文简述排尿反射的神经支配及分级调节过程,汇总CSVD 在传统影像学特征方面取得的最新进展,并提出解释CSVD 排尿障碍可能的神经机制,旨在加深临床医师对CSVD 排尿障碍综合性的理解和认识。

Previous studies have posited that bladder function is highly dependent on the central nervous system, with the concept of the "vascular-brain-bladder axis" being widely applied to explain neurogenic urinary disorders.Cerebral small vessel disease (CSVD) represents a substantial health challenge in the elderly, with urinary dysfunction as one of its primary non-cognitive motor symptoms.These symptoms manifest diversely as urinary frequency, urgency, nocturia, and urge incontinence.The specific mechanisms underlying CSVD-related urinary dysfunction remain unclear.Recent research has identified a strong correlation between heart rate variability—a marker of autonomic function—and CSVD-related urinary dysfunction.Additionally, multiple studies have demonstrated that traditional imaging characteristics are also associated with these urinary symptoms.This paper aims to summarize the neural control and graded regulation of the micturition reflex, review the latest advancements in traditional imaging characteristics of CSVD,and propose potential neural mechanisms explaining CSVD-induced urinary dysfunction, with the goal of enhancing clinical physicians' comprehensive understanding and recognition of CSVD-related urinary issues.

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