BRAIN and NERVE－神経研究の進歩66巻5号

2014年05月発行

特集 アセチルコリンと神経疾患―100年目の現在地

神経因性膀胱―アセチルコリンの関与を含めて

著者： 榊原隆次¹ 舘野冬樹¹ 岸雅彦¹ 露崎洋平¹ 内山智之² 山本達也³

所属機関： ¹東邦大学医療センター佐倉病院内科学神経内科 ²獨協医科大学排泄機能センター ³千葉大学大学院医学研究院神経内科学

ページ範囲：P.527 - P.537

文献概要

排尿障害は，自律神経症候の中で非常に頻度が高いものである。このうち残尿・尿閉は繰り返す尿路感染症，腎後性腎不全をきたし予後を悪化させる懸念があり，過活動膀胱（尿意切迫・頻尿・尿失禁）は生活の質を悪化させる。コリン系神経は，運動神経，認知機能とともに自律神経の中の副交感神経系（および交感神経節）に深く関わっており，特に神経因性膀胱では，コリン系神経の障害が大きく関与している。本稿では神経因性膀胱の主な病態・治療とアセチルコリンの関わりについて，糖尿病性ニューロパチー，高齢者のアルツハイマー病・白質型多発脳梗塞を例示しながら述べた。神経因性膀胱は，適切な治療薬で改善が得られることが多いことから，積極的な治療介入が望まれる。

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