下尿路症状患者中间质性膀胱炎/膀胱疼痛综合征的发病情况及危险因素分析

Risk factors for interstitial cystitis/painful bladder syndrome in patients with lower urinary tract symptoms presenting for urologic care

目的 明确具有下尿路症状（LUTS）而排除泌尿系感染或良性前列腺增生的间质性膀胱炎/膀胱疼痛综合征（IC/PBS）患者的发病相关危险因素,为临床诊断、治疗乃至预防提供理论指导.方法 对2008年11月20日至2012年8月24日8家医院泌尿外科门诊就诊的表现为LUTS的954例患者,使用标准化问卷调查和有效的检查排除泌尿系感染及良性前列腺增生等诊断,明确IC/PBS诊断.对IC/PBS患者可能的风险因素应用Fisher检验、Pearson χ2检验和多元因素回归方法进行分析.结果 954例有LUTS症状的患者中427例（44.7%）符合IC/PBS诊断.女性LUTS症状患者中IC/PBS发生率[51.7%（254/491）]高于男性LUTS症状患者[37.4%（173/463）,P〈0.05].女性患者中IC/PBS与食用刺激性食物（OR：81.16,95%CI：11.50~590.00,P=0.001）、肛肠疾病（OR：54.90,95%CI：9.52~401.00,P=0.001） 显著相关.男性患者中IC/PBS与咖啡因摄入（OR：4.29,95%CI：1.86~9.86,P=0.001）有显著相关性.结论 食用刺激性食物、肛肠疾病和咖啡因摄入是IC/PBS发生的潜在危险因素,它们对IC/PBS的作用机制需要进一步研究.

Objective To identify the risk factors in interstitial cystitis/painful bladder syndrome （IC/PBS） patients with lower urinary tract symptoms （LUTS） without urinary tract infection or benign prostate hyperplasia in China. Methods A total of 954 outpatients with LUTS presenting for care to urology clinics at 8 hospitals throughout China from November 20,2008 to August 24,2012 were surveyed with a standardized questionnaire and validated outcome measures. The definitions for IC/PBS based on the O＇Leary-Sant interstitial cystitis symptom and problem indices were used. The possible risk factors was analyzed with the Fisher＇s exact and Pearson ehi-square tests. And multivariate predictive models were developed with binary Logistic regression methods. Results There were 491 females and 463 males. And 44. 7% （427/954） met the criteria for IC/PBS. There was significant gender difference （51.7% （254/491 ） vs 37.4% （ 173/463 ） , P 〈 0. 05 ）. After adjusting for confounding factors, bladder pain was significantly associated with stimulatory foods （ OR： 81.16,95% CI： 11.50 - 590. 00 ,P = 0. 001 ） and anorectal disease （OR： 54.90,95% CI： 9.52 - 401.00, P = 0. 001 ） in females. Caffeine beverage intake （ OR： 4.29, 95% CI： 1.86- 9. 86 ,P = 0.001 ） was the only modifiable association according to multivariate analysis of males. Conclusions Stimulatory foods, anorectal disease and caffeine beverages are potential risk factors for IC/PBS. Further studies are necessary to determine their roles in the pathogenesis of this disorder.