间质性膀胱炎/膀胱疼痛综合征患者生活质量及相关因素分析

doi:10.19723/j.issn.1671-167X.2021.04.005

摘要/Abstract

摘要：

目的: 评估间质性膀胱炎/膀胱疼痛综合征(interstitial cystitis/bladder pain syndrome,IC/BPS)患者的生活质量,比较其与膀胱过度活动(overactive bladder,OAB)患者之间的差异,探索影响IC/BPS患者生活质量的相关因素。方法: 收集就诊于北京医院等全国多家医学中心门诊的女性IC/BPS患者人口学资料,对患者的生活质量进行多角度问卷调查并与OAB患者资料进行对比。根据生活质量影响程度,将IC/BPS患者分为轻-中度组与重度组,分析影响IC/BPS患者生活质量的相关因素。结果: 共纳入109例IC/BPS患者,平均年龄(46.4±14.3)岁,平均病程(39.4±51.6)个月。与OAB患者相比,IC/BPS组患者的平均病程较长(P=0.008),初次因本疾病就诊的患者比例较低(P<0.001),美国泌尿协会症状指数(American Urological Association symptom index, AUA-SI)评分较高(P<0.001),体重指数(body mass index,BMI)较低(P=0.016),便秘发生率较低(P=0.006)。IC/BPS对患者家庭生活方面的影响最大,其次为出行社交。IC/BPS相关症状对患者家庭生活的影响程度评分显著高于OAB组(P=0.003),困扰IC/BPS患者的症状前三位分别是疼痛(45%)、尿频(28%)、尿急(17%),IC/BPS患者储尿期症状对生活质量影响的评分显著高于OAB患者(P<0.001),咖啡因摄入(P=0.034)、便秘(P=0.003)可能是影响IC/BPS患者生活质量的相关因素。结论: IC/BPS对患者的生活质量影响较大,咖啡因摄入、便秘可能是影响IC/BPS患者生活质量的相关因素。泌尿科医生可以建议患者通过改变饮食和生活方式以减轻症状,提高患者的生活质量。

关键词: 间质性膀胱炎, 膀胱, 过度活动性, 生活质量, 危险因素

Abstract:

Objective: To evaluate the quality of life of patients with interstitial cystitis/bladder pain syndrome (IC/BPS), to compare the difference between IC/BPS and overactive bladder (OAB) pain syndrome, and to explore the related factors affecting the quality of life of IC/BPS patients. Methods: The demographic data of female outpatients with IC/BPS in Beijing Hospital and other medical centers in China were collected. The quality of life of the patients was investigated by multi-angle questionnaires and compared with the data of OAB patients. According to the influence degree of quality of life, the patients with IC/BPS were divided into mild-moderate group and severe group. Results: In this study, 109 patients with IC/BPS were included. The average age was (46.4±14.3) years and the average course of disease was (39.4±51.6) months. Compared with the OAB patients, the patients in IC/BPS group had a longer average course of disease (P=0.008), a lower proportion of the patients of first visit for the disease (P<0.001), a higher score of the American Urological Association symptom index (AUA-SI) (P<0.001), a lower body mass index (BMI) ratio (P=0.016), and a lower incidence of constipation (P=0.006). IC/BPS had the greatest impact on family life, followed by social activity. The score of IC/BPS related symptoms on family life was significantly higher than that of the OAB group (P=0.003). The top three symptoms of the IC/BPS patients were pain (45%), frequency (28%) and urgency (17%). The score of quality of life in the IC/BPS patients was significantly higher than that in the OAB patients (P<0.001). Caffeine intake (P=0.034) and constipation (P=0.003) might be the factors influencing the quality of life of the patients with IC/BPS. Conclusion: IC/BPS has a great influence on the quality of life of patients. Caffeine intake and constipation may be related factors affecting the quality of life of patients with IC/BPS. Urologists should recommend changes in diet and lifestyle to reduce symptoms and improve the patients’ quality of life.

Key words: Interstitial cystitis, Urinary bladder, overactive, Quality of life, Risk factors

中图分类号:

R694

王佳文,刘敬超,孟令峰,张威,刘晓东,张耀光. 间质性膀胱炎/膀胱疼痛综合征患者生活质量及相关因素分析[J]. 北京大学学报（医学版）, 2021, 53(4): 653-658.

WANG Jia-wen,LIU Jing-chao,MENG Ling-feng,ZHANG Wei,LIU Xiao-dong,ZHANG Yao-guang. Quality of life and related factors in patients with interstitial cystitis/bladder pain syndrome[J]. Journal of Peking University (Health Sciences), 2021, 53(4): 653-658.

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Items	IC/BPS (n=109)	OAB (n=461)	P value
Age/years, $\bar{x}±s$	46.4±14.3	46.2±13.1	0.852
Disease duration/months, $\bar{x}±s$	39.4±51.6	27.0±40.8	0.008
BMI, $\bar{x}±s$	22.1±2.8	22.9±3.0	0.016
Smoking, n (%)			0.315
No	108 (99.1)	446 (96.7)
Yes	1 (0.9)	15 (3.3)
Drinking, n (%)			0.759
No	106 (97.2)	453 (98.3)
Yes	3 (2.8)	8 (1.7)
Caffeine intake, n (%)			0.956
No	103 (94.5)	435 (94.4)
Yes	6 (5.5)	26 (5.6)
Constipation, n (%)			0.006
No	91 (83.5)	325 (70.5)
Yes	18 (16.5)	136 (29.5)
Marital status, n (%)			0.090
Married	98 (89.9)	435 (94.4)
Unmarried or divorced	11 (10.1)	26 (5.6)
First visit due to LUTS, n (%)			<0.001
No	29 (26.6)	21 (4.6)
Yes	80 (73.4)	440 (95.4)
OABSS scores, $\bar{x}±s$	7.1±3.2	6.6±3.2	0.210
AUA-SI scores, $\bar{x}±s$	14.5±6.7	11.7±5.9	<0.001

Items	IC/BPS (n=109), M (P₂₅, P₇₅)	OAB (n=461), M (P₂₅, P₇₅)	P value
Social activities	4 (3, 5)	4 (3, 5)	0.165
Work	2 (1, 3)	2 (1, 4)	0.116
Sports	2 (0, 3)	2 (1, 4)	0.057
Daily life	4 (4, 5)	4 (3, 5)	0.003
Sexual life	2 (0, 4)	2 (1, 4)	0.251
Psychological emotions	2 (0, 3)	2 (1, 4)	0.187

Impacts on quality of life score	IC/BPS (n=109), M (P₂₅, P₇₅)	OAB (n=461), M (P₂₅, P₇₅)	P value
Storage symptoms	8 (6, 8)	6 (5, 7)	<0.001
Voiding symptoms	3 (1, 6)	4 (1, 5)	0.846
Post-voiding symptoms	4 (1, 6)	4 (1, 6)	0.735

Items	Mild and moderate (n=46)	Severe (n=63)	P value
Age/years, $\bar{x}±s$	48.4±15.6	45.0±13.3	0.302
Disease duration/months, $\bar{x}±s$	40.9±56.4	38.3±48.3	0.789
BMI, $\bar{x}±s$	21.8±2.7	22.3±2.9	0.805
Smoking, n (%)			0.578
No	46 (100.0)	62 (98.4)
Yes	0 (0)	1 (1.6)
Drinking, n (%)			0.189
No	46(100.0)	60 (95.2)
Yes	0 (0)	3 (4.8)
Caffeine intake, n (%)			0.034
No	46 (100.0)	57 (90.5)
Yes	0 (0)	6 (9.5)
Constipation, n (%)			0.003
No	44 (95.7)	47 (74.6)
Yes	2 (4.3)	16 (25.4)
Marital status, n (%)			0.234
Married	43 (93.5)	55 (87.3)
Unmarried or divorced	3 (6.5)	8 (12.7)
First visit due to LUTS, n (%)			0.548
No	12 (26.0)	17 (27.0)
Yes	34 (74.0)	46 (73.0)