慢性前列腺炎相关危险因素的多中心联合调查研究

Multicenter study of the risk factors for chronic prostatitis

目的根据我国西北地区海拔梯度差及年均温差大的地理特点,以多中心联合方式调查西北地区高原环境下慢性前列腺炎的相关危险因素。方法对2005年6月-2008年5月在西北各省泌尿外科门诊确诊的943例慢性前列腺炎患者进行相关问卷调查,同时选择同期内在同一门诊就诊或陪同就诊的健康人群作为对照组,进行病例对照研究。调查内容包括国际前列腺炎症状评分指数表、个人基本信息及居所地理环境信息、经济及受教育情况、生活习惯、身心状况、婚姻状况、性活动状况及疾病史,共29个可能的危险因素。采用单因素及多因素条件logistic回归分析慢性前列腺炎可能的相关危险因素。结果最终纳入的研究对象共624例,问卷有效回收率为66.2%。经单因素及多因素logistic回归分析,最终选入模型的可能相关危险因素有8个,分别是泌尿系统感染(OR=6.301,P<0.001)、频繁手淫(OR=5.334,P<0.001)、寒冷气候(OR=4.609,P=0.001)、前列腺肥大(OR=4.145,P<0.001)、心理压力(OR=3.072,P=0.005)、高海拔(OR=2.109,P=0.017)、运动量减少(OR=1.533,P=0.023)及酗酒(OR=1.503,P=0.019)。结论慢性前列腺炎的发生发展与环境因素、生活习惯、心理因素及泌尿生殖系统病变等多种因素相关,对于这些因素的具体作用机制仍须深入研究。

Objective The objective of this multicenter study was to identify the risk factors for chronic prostatitis in urological outpatients residing in highlands of northwest China where the altitude and average annual temperature were different among different areas.Methods From June 2005 to May 2008,a total of 943 outpatients from different urological centers with chronic prostatitis were consecutively enrolled in this prospective epidemiological case-control study.During the period,the control subjects consisted those who did not meet the pain/discomfort definition of chronic prostatitis/chronic pelvic pain syndrome（CP/CPPS）and those who meet the exclusion criteria for this study were recruited from the same urological centers.Subjects completed the multiple-choice questionnaires of the International Institutes of Health Chronic Prostatitis Symptom Index,personal data,geographical information of their dwelling,sociodemographic characteristics,living style,psychosomatic status,sexual behaviors and clinical history of each patient were collected.A total of 29 possible risk factors for prostatitis were analyzed using conditional univariate and multivariate logistic regression methods to identify finally the possible risk factors.Results Altogether,624 men returned the questionnaires giving a response rate of 66.2%.In the univariate and developed multivariate logistic regression model,urinary tract infection（OR=6.301,P〈0.001）,frequent masturbation（OR=5.334,P〈0.001）,cold climate（OR=4.609,P=0.001）,history of prostate hypertrophy（OR=4.145,P〈0.001）,high psychic stress（OR=3.072,P=0.005）,high altitude（OR=2.109,P=0.017）,diminished physical activity（OR=1.533,P=0.023）and alcohol indulgence（OR=1.503,P=0.019）were related to an increased risk of prostatitis.Conclusions The findings suggest many risk factors are associated with chronic prostatitis.Further studies are necessary to determine whether they play a role in the pathogenesis of CP/CPPS.