合并疾病的良性前列腺增生患者下尿路症状对生活质量的影响  

Effect of comorbidity on the severity of lower urinary tract symptoms and quality of life in patients with benign prostate hyperplasia

作　　者：胡文学[1] 钱芸娟[1] 余枫[1] 何文娜[1] 刘伟[1] 吴燕华[1] 方晓武[1] 郝文科[1] 

机构地区：[1]广东省人民医院广东省医学科学院老年医学研究所肾内科,广州市510180

出　　处：《中华老年医学杂志》2014年第2期166-168,共3页Chinese Journal of Geriatrics

基　　金：广东省医学科研基金（B2012007）

摘　　要：目的探讨合并疾病的良性前列腺增生（BPH）患者下尿路症状对生活质量（QOL）的影响。方法对确诊BPH的患者采取问卷调查，国际前列腺症状评分（IPSS）评价下尿路症状，QOI。评分以评价生活质量，B超测定前列腺体积、膀胱残余尿量，尿流动力学检查测定最大尿流率，用Charlson合并症指数（CCI）对合并疾病进行评分并把患者分为无、低和高合并症组。分别比较3组患者的IPSS评分、QOL评分及相关指标，并分析影响IPSS、QOL评分的因素。结果193例BPH并存合并症的患者171例（88．6％），无合并症的患者22例（11．4％）。在合并症中，心血管疾病161例（94．2％）、糖尿病78例（45．6％）、脑血管系统疾病51例（29．8％）、慢性呼吸系统疾病34例（19．9％）、肝病8例（4．7％）、肿瘤5例（2．9％）。高合并症组的IPSS评分及QOL评分高于低合并症组及无合并症组（P〈O．05），最大尿流率高合并症组低于无合并症组（P〈0．05），而组间前列腺体积及膀胱残余尿量则差异无统计学意义（P〉O．05）。多元线性回归分析显示，CCI、年龄、前列腺体积与IPSS评分存在线性依存关系（标准化回归系数分别为0．26、0．17、0．24，均P〈0．05），即CCI越高、年龄越大、前列腺体积越大，IPSS评分越高，下尿路症状越严重。CCI、年龄与QOL评分呈线性关系，其标准化回归系数为0．16、0．26（均P〈0．05），即CCI越高、年龄越大，QOL评分越高，生活质量越低。结论合并疾病普遍存在于BPH患者中，且CCI高的BPH患者下尿路症状重，生活质量低。Objective To investigate the effects of comorbidity on the severity of lower urinary tract symptoms and quality of life in patients with benign prostate hyperplasia. Methods International prostate symptom score（IPSS） and quality of life（QOL）in patients diagnosed as BPH were assessed by questionnaires. The volumes of prostate and residual urine were detected by type-B ultrasonic. The urine flow rate was determined by urodynamic study. The conditions of comorbidities were investigated by Charlson comorbidity index（CCI）. According to CCI, patients were divided into CCI high group, CCI low group and CCI zero group. IPSS, QOL and their related factors were analyzed and compared among the groups. Results A total of 193 patients with BPH were recruited. There were 171 patients with eomorbidities. Among these comorbidities, cardiovascular diseases accounted for 88.6% （n = 161）, diabetes accounted for 45.6% （n=81）, cerebrovascular diseases accounted for 29.8% （n= 51）, chronic respiratory diseases accounted for 19.9% （n=34）, liver diseases accounted for 4.7%（n=8） and tumors accounted for 2.9%（n=5）. The scores of IPSS and QOL were significantly higher in CCI high group than in CCI low group and CCIzero group（both P d0.05）. The maximum rates of urine flow were significantly higher in CCI high group than in CCI zero group（P〈0.05）. There were no significant differences in volume of prostate and residual urine between groups（all P〉0.05）. Multiple linear regression analysis revealed that CCI, age, the volume of prostate were positively correlated to IPSS score （standardized regression coefficient were 0.26,0.17, 0.24, respectively, all P〈0.05）. And CCI and age were positively correlated to QOL （standardized regression coefficient were 0. 16 and 0.26, both P 〈 0.05）. Conclusions Comorbidities are commonly presented in BPH patients. BPH patients with high CCI have severe lower urinary tract symptoms and lower QOL.

关 键 词：前列腺增生 生活质量 

分 类 号：R697.3[医药卫生—泌尿科学]