上海浦东新区良性前列腺增生合并膀胱过度活动症的流行病学调查

Epidemic investigation of benign prostatic hyperplasia with coexisting overactive bladder in Shanghai Pudong New Area

目的调查上海浦东新区≥50岁人群良性前列腺增生(BPH)合并膀胱过度活动症(OAB)的患病率、相关危险因素及其对患者生活质量的影响。方法运用描述性流行病学多阶段随机抽样方法,在上海浦东新区一般人群中抽取≥50岁BPH患者1 632名,对下尿路症状(LUTS)情况采用国际前列腺症状评分(IPSS)和生活质量评分(QoL)进行评估;应用国际勃起功能指数问卷-5(IIEF-5)记录患者的阴茎勃起功能情况;对合并OAB患者采用膀胱过度活动症症状评分(OABSS)和King健康问卷评分(KHQ)调查;评估BPH合并OAB对患者生活质量的影响。结果共获得有效问卷1 476份。BPH合并OAB的总患病率为39.6%,50岁~、60岁~、70岁~、80岁~及≥90岁年龄组的患病率分别为28.1%、34.2%、44.6%、48.2%、51.5%。年龄、前列腺体积及焦虑抑郁是BPH合并OAB的危险因素。随着年龄与前列腺体积的增加,BPH合并OAB患病率升高,患者LUTS加重,IPSS、QoL、OABSS、KHQ评分增加,IIEF-5评分下降。KHQ评分较高的项目有一般健康状况(26.9±7.4)分、排尿问题严重程度(29.6±8.2)分和睡眠/精力(32.5±8.3)分。结论浦东新区≥50岁人群BPH合并OAB患病率为39.6%,其患病率与年龄、前列腺体积及焦虑抑郁程度呈正相关;BPH可能是男性OAB的患病危险因素之一,而BPH合并OAB可严重影响患者生活质量。

Objective To investigate the prevalence, relative risk factors and the impact on health related quality of life of benign prostatic hyperplasia （BPH） with coexisting overactive bladder （OAB） in males aged 50 and above in Shanghai Pudong New Area. Methods A total of 1 632 men over 50 years old in Shanghai Pudong New Area were selected among general populations with multi-stage sampling of descriptive epidemiological method. International Prostate Symptom Score （IPSS） and quality of life （QoL） score were recorded to evaluate the lower urinary tracts symptoms （LUTS）. The International Index of Erectile Function-5 （IIEF-5） questionnaire was used to assess the erectile function. The Overactive Bladder Symptom Score （OABSS） and King＇s health questionnaire （KHQ） were surveyed to evaluate the impact of BPH with coexisting OAB on health related quality of life. Results Altogether 1 476 men with complete and effective data were included in the investigation. The overall prevalence of BPHwith coexisting OAB was 39.6% （584/1476）. In the 50-59,60-69,70-79,80-89 and ≥90 year groups,the prevalence of BPH with coexisting OAB was 28.1% （81/288） ,34. 2% （124/363）,44.6% （243/545）,48.2% （119/ 247） and 51.5 %（17/33）, respectively. Age, prostate volume,severity of LUTS and degree of anxiety were associated risk factors for BPH with coexisting OAB. With increased age and prostate volume, the prevalence of BPH with coexisting OAB and the IPSS, QoL, OABSS and KHQ score increased, the LUTS aggravated,while the IIEF-5 score decreased. The KHQ score was relatively high in general health perception （26.9±7.4） ,severity of urination problems （29.6±8.2） ,sleep / energy （32.5±8.3）. Conclusion The prevalence of BPH with coexisting OAB is 39.6% in Shanghai Pudong New Area. The prevalence has a positive correlation with age, BMI, prostate volume, severity of LuTS and degree of anxiety and depression. BPH is likely to be one of the risk factors of male OAB. The symptoms of BPH with coexisting OAB have a significant effect on the quality of life.