诊断和治疗建议 - - 多发性硬化症患者中尿流量计的间隔计可靠性
Anke K Jaekel1,2, Julia Rieger1, Anna-Lena Butscher2
1Clinic for Urology, University Hospital Bonn, 53127 Bonn, Germany.
Biomedicines
|July 27, 2024
概括
在患有多发性硬化症 (PwMS) 的人群中诊断神经性下泌尿道功能障碍 (NLUTD) 的尿液流量计 (UF) 的interrater可靠性显示出低一致. 虽然肉毒素治疗建议的可靠性很好,但诊断一致性很差,这表明UF.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 神经泌尿病学 - 神经泌尿病学
- 临床评估 临床评估
背景情况:
- 泌尿流量计 (UF) 是一种标准的泌尿学检查,用于发现神经性下尿道功能障碍 (NLUTD).
- 有限的数据存在于UF的interrater可靠性 (IRR) 治疗建议,特别是在多发性硬化症 (PwMS) 患者.
- 该研究前性地评估了UF在诊断和推PwMS治疗中的IRR.
研究的目的:
- 评估尿流量计 (UF) 在诊断神经性下尿道功能障碍 (NLUTD) 中的interrater可靠性 (IRR).
- 在指导多发性硬化症 (PwMS) 患者的治疗建议时评估UF的IRR.
主要方法:
- 四名评级人员评估了92名多发性硬化症患者 (PwMS) 的尿液流量计 (UF) 数据.
- 诊断标准包括正常的发现,detrusor过度活跃 (DO),detrusor低活跃 (DU),detrusor-sphincter异能 (DSD) 和膀出口阻塞 (BOO).
- 治疗选择范围从没有治疗到导管安置,药物,肉毒素 (BTX),神经调节 (NM) 和物理治疗/生物反 (P/BF).
- 使用kappa (κ) 统计数据量化了Interrater可靠性.
主要成果:
- 在所有诊断类别中观察到低卡帕 (κ) 值:正常发现 (0.22),DO (0.17),DU (0.07),DSD (0.14) 和BOO (0.18).
- 治疗建议的可靠性各不相同,其中肉毒素 (BTX) 达到0.71.7的最高卡帕 (κ).
- "没有治疗" (NO) 和"导管放置" (CAT) 的可靠性分别为0.38和0.44,中等.
结论:
- 个体评定者的影响显著影响了多发性硬化症 (PwMS) 患者的尿道流量计 (UF) 评估.
- 在PwMS中,UF对NLUTD的诊断可靠性很低,这质疑了其独立价值.
- 尿动力学 (UD) 仍然是PwMS中NLUTD诊断的黄金标准,需要进一步对UF和UD进行比较分析.
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