中国门诊女性下尿路症状诊疗状况的多中心调查  

A multicenter survey on the diagnosis and treatment of lower urinary tract symptoms in Chinese female outpatients

作　　者：王佳文 孟令峰[2] 张威[2] 马天明 刘晓东 张耀光 WANG Jiawen;MENG Lingfeng;ZHANG Wei;MA Tianming;LIU Xiaodong;ZHANG Yaoguang(Peking University Fifth School of Clinical Medicine,Beijing 100730;Department of Urology,Beijing Hospital,National Center of Gerontology,Beijing 100730,China)

机构地区：[1]北京大学第五临床医学院,北京100730 [2]北京医院泌尿外科,国家老年医学中心,北京100730

出　　处：《现代泌尿外科杂志》2021年第7期554-557,617,共5页Journal of Modern Urology

基　　金：国家重点研发计划(No.2018YFC2002200)。

摘　　要：目的通过分析国内泌尿外科门诊就诊女性下尿路症状(LUTS)患者资料,了解国内女性LUTS诊断与治疗的变化情况。方法于2011年和2015年对国内多中心泌尿外科门诊就诊的女性LUTS患者进行横断面调查研究,共纳入患者3515例,其中一期780例,二期2735例。调查的内容包括患者一般情况、相关人口学特征、本次及既往诊断信息、治疗方案、用药信息、国际前列腺症状评分(IPSS)问卷和膀胱过度活动症患者症状评估(OABSS)问卷等。结果我国女性LUTS患病率较高,临床表现以储尿期症状为主。所有因LUTS就诊的女性患者中,最终被诊断为膀胱过度活动症(OAB)的患者最多。一期患者主要诊断出的疾病前3位分别为OAB(58.7%)、泌尿系感染(13.8%)、尿路结石(3.0%);二期患者主要诊断出的疾病前3位分别为OAB(67.8%)、泌尿系感染(27.8%)、压力性尿失禁(7.2%)。二期调查中就诊女性无OAB症状和轻度OAB症状患者比例提高,中度OAB症状患者比例降低,差异有统计学意义(P<0.001),但就诊患者OAB症状仍以中重度为主。二期调查中诊断流程改善明显,IPSS问卷、OABSS问卷使用率达100%,尿常规、尿流率、残余尿测定使用频率较一期增加。药物等保守治疗是女性LUTS患者主要治疗选择。近70%的OAB患者采用单药治疗,且M受体拮抗剂已成为女性OAB患者的主要用药。结论我国女性LUTS诊断治疗规范化、流程化程度得到提高,但患者仍以中重度为主。Objective To investigate the diagnosis and treatment of female lower urinary tract symptoms(LUTS)in China.Methods A cross-sectional study was conducted in 2011 and 2015 among 3515 female LUTS patients,including 780 in the first stage and 2735 in the second stage.The survey included the general condition of patients,demographic characteristics,current and previous diagnosis information,treatment and medications.International Prostate Symptom Score(IPSS)and Overactive Bladder Symptom Score(OABSS)were also investigated.Results The prevalence of LUTS among Chinese women was high.LUTS mainly manifested with urine storage symptoms,and most cases were overactive bladder(OAB).In the first stage,OAB(58.7%),urinary tract infection(13.8%)and urinary calculi(3.0%)ranked the top three diagnoses,while in the second stage,OAB(67.8%),urinary tract infection(27.8%)and stress urinary incontinence(7.2%)were the top three.In the second stage,the proportion of patients without OAB symptoms and mild OAB symptoms increased,while the proportion of patients with moderate OAB symptoms decreased(P<0.001).The use rates of IPSS and OABSS were 100%in the second stage,and the use rates of routine urine test,urine flow rate and residual urine test were higher than those in the first stage.Conservative treatment such as medications was the main treatment choice.Approximately 70%of OAB patients received monotherapy,especially M receptor antagonists.Conclusion The standardization and process of diagnosis and treatment of LUTS in Chinese women have been improved,but the majority are still moderate to severe cases.

关 键 词：下尿路症状 膀胱过度活动 诊疗现状 多中心调查 

分 类 号：R695.1[医药卫生—泌尿科学]