中国高血压女性尿失禁及其亚型的危险因素:一项为期4年的前瞻性队列研究  

Risk factors for urinary incontinence and its subtypes in Chinese hypertensive women:a 4-year prospective cohort study.

作　　者：尹嘉惠 庞海玉[2] 刘静怡 朱兰[3] 乔友林[1] YIN Jia-hui;PANG Hai-yu;LIU Jing-yi;ZHU Lan;QIAO You-lin(School of Population Medicine and Public Health,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;不详)

机构地区：[1]中国医学科学院北京协和医学院群医学及公共卫生学院,北京100730 [2]中国医学科学院北京协和医学院北京协和医院临床医学研究所转化医学国家重大科技基础设施预防与早期干预平台,北京100730 [3]中国医学科学院北京协和医学院北京协和医院妇产科国家妇产疾病临床医学研究中心,北京100730

出　　处：《中国实用妇科与产科杂志》2024年第5期549-555,共7页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家重点研发计划(2021YFC2701300);国家自然科学基金(72104247);中央高水平医院临床科研业务费资助项目(2022-PUMCH-A-023)。

摘　　要：目的探讨高血压女性新发尿失禁(UI)及其亚型的危险因素。方法全国“女性盆底功能障碍性疾病流行病学调查”采用多阶段分层整群抽样的方法,纳入标准:≥20岁、在登记地区居住至少5年;排除标准:妊娠期、患严重精神或身体疾病。该队列在2014年5月至2016年1月期间进行基线调查,并于2018年6月至12月进行随访。该研究基于上述调查数据,纳入基线患高血压的女性,排除基线患UI或其他盆底障碍性疾病的女性,最终纳入1183例高血压女性。采用泊松回归评估高血压女性新发UI、压力性尿失禁(SUI)、急迫性尿失禁(UUI)及混合性尿失禁(MUI)与潜在危险因素的关系。结果新发UI的危险因素是年龄≥60岁(RR=1.60,95%CI 1.11~2.30)、初高中文化水平(初中:RR=1.68,95%CI 1.13~2.50;高中:RR=1.70,95%CI 1.08~2.68)、吸烟(RR=1.86,95%CI 1.07~3.23)和高体重指数(BMI)(超重:RR=1.90,95%CI 1.32~2.73;肥胖:RR=2.31,95%CI 1.40~3.82)。高BMI(超重:RR=2.00,95%CI 1.27~3.16;肥胖:RR=2.51,95%CI 1.33~4.73)是SUI的危险因素。年龄≥60岁(RR=3.20,95%CI 1.20~8.52)和农村(RR=2.65,95%CI 1.20~5.86)的高血压女性易新发UUI。初高中文化水平(初中:RR=3.26,95%CI 1.14~9.28;高中:RR=3.81,95%CI 1.27~11.40)和绝经后(RR=3.79,95%CI 1.13~12.68)高血压女性易新发MUI。结论高血压女性中,新发UI的危险因素是高龄、初高中文化水平、高BMI和吸烟;新发SUI的危险因素是高BMI;新发UUI的危险因素是高龄和农村地区;新发MUI的危险因素是初高中文化水平和绝经。Objective To analyze the risk factors for new-onset urinary incontinence(UI)and its subtypes in hypertensive women.Methods The National Epidemiological Survey of Female Pelvic Floor Dysfunction adopted a multi-stage stratified cluster sampling method,inclusion criteria≥20 years old and residing in the registered area for at least 5 years,and exclusion criteria being pregnancy or severe mental or physical illness.The cohort was surveyed at baseline between May 2014 and January 2016 and followed up between June and December 2018.Based on the survey data mentioned above,this study included women with hypertension at baseline,excluded women with UI or other pelvic floor disorders at baseline,and ultimately included 1183 hypertensive women.Poisson regression was used to assess the relationship between new-onset UI,stress urinary incontinence(SUI),urge urinary incontinence(UUI)and potential risk factors in hypertensive women.Results Risk factors for UI included age≥60 years(RR=1.60,95%CI 1.11-2.30),intermediate educational level(junior middle school:RR=1.68,95%CI 1.13-2.50;senior school:RR=1.70,95%CI 1.08-2.68),smoking(RR=1.86,95%CI 1.07-3.23),and high body mass index(BMI)(overweight:RR=1.90,95%CI 1.32-2.73;obesity:RR=2.31,95%CI 1.40-3.82).High BMI(overweight:RR=2.00,95%CI 1.27-3.16;obesity:RR=2.51,95%CI 1.33-4.73)was a risk factor for SUI.Hypertensive women over the age of 60 years(RR=3.20,95%CI 1.20-8.52)and in the rural areas(RR=2.65,95%CI 1.20-5.86)were prone to developing new-onset UUI.Hypertensive women with intermediate educational level(junior middle school:RR=3.26,95%CI 1.14-9.28;senior school:RR=3.81,95%CI 1.27-11.40)and postmenopausal hypertensive women(RR=3.79,95%CI 1.13-12.68)were susceptible to new-onset MUI.Conclusion Among hypertensive women,the risk factors for new-onset UI were advanced age,junior middle school and senior school education,high BMI,and smoking,for new-onset SUI were high BMI,and for new-onset UUI were advanced age and rural region,for new-onset MUI were junior middle school,senior

关 键 词：尿失禁 高血压 危险因素 

分 类 号：R711.59[医药卫生—妇产科学]