干燥综合征合并间质性膀胱炎的研究

Study on Sjgren's syndrome complicated by interstitial cystitis

目的:总结干燥综合征(SS)合并间质性膀胱炎(IC)的临床特点和治疗方法。方法:收集1993~2016年IC合并SS的病例报道,并对其进行回顾性分析。结果:21例患者,全部为女性,平均年龄为54(40~77)岁。62%(13/21)的患者先表现出SS的临床症状,平均7年后出现IC的症状。所有患者均有IC的尿路症状,19例患者尿频,10例患者下腹部疼痛,13例患者尿急,13例患者尿痛,4例患者血尿,3例患者排尿困难。有3例患者双侧肾盂输尿管扩张积水,其中2例患者出现急性肾功能衰竭。有17例患者描述了治疗方案,其中11例患者接受了糖皮质激素治疗,9例患者接受了免疫抑制治疗,7例患者接受局部膀胱治疗,2例患者因急性梗阻性肾功能衰竭而留置输尿管支架管。结论:SS患者出现明显的尿路症状,尿培养提示阴性,临床医师应考虑SS合并IC。糖皮质激素和免疫抑制剂对患者有较好的效果,局部膀胱治疗对患者有一定的效果。

Objective：To summarize the clinical characteristics and therapies in interstitial cystitis（IC）associated with Sjgren＇s syndrome（SS）.Method：The case reports of IC associated with SS collected from medical literature between 1993 and 2016 were retrospectively analyzed.Result：Twenty-one cases of SS and IC have been reported in women,with a mean age of 54 years old.SS appeared first in 62%（13/21）of cases,a mean of 7 years before IC.The symptoms of IC included pollakiuria（n=19）,lower abdominal pain（n=10）,urinary urgency（n=13）,painful micturition（n=13）,hematuria（n=4）and dysuria（n=3）.Urinary dilatation occurred in three cases,leading to acute renal failure in two patients.Treatment was reported for 17 patients,11 of whom（78%）received corticosteroid treatment.Immunosuppressive treatment was added in nine cases.Local bladder treatments were performed in seven patients.A urinary catheter was inserted in two cases of acute obstructive renal failure.Conclusion：Urinary symptoms without infection should lead the physician to consider a diagnosis of IC in SS patients.Corticosteroid and immunosuppressive treatment may be effective and local treatments have been tried.