间质性膀胱炎与女性激素失调的临床相关性研究

摘要

目的 探讨间质性膀胱炎(interstitial cystitis,IC)与女性激素失调的临床相关性.方法 回顾性分析2006年1月至2012年4月收治的58例女性IC患者的临床资料.年龄21～76岁,平均(40.2±12.4)岁.病程9～120个月,平均(64.3±55.7)个月.记录患者月经周期第1、12、22天的O'Leary-Sant评分、盆腔疼痛与尿急/尿频(PUF)评分,探讨女性IC患者尿频、尿急、膀胱疼痛等症状与月经周期的关系,以及未绝经患者与绝经患者各项评分的差异,调查女性IC患者伴发性激素失调病的发病情况. 结果51例未绝经患者月经周期第1天膀胱疼痛和尿频、尿急症状发生率最高,分别为54.9％(28/51)和60.8％(31/51)；7例绝经患者症状加重无明显规律性.月经周期第1、12、22天O'Leary-Sant评分分别为26.60±2.37、21.62±1.98、22.40±2.68,第1天与第12、22天比较差异均有统计学意义(P＜0.05),第12天与第22天比较差异无统计学意义(P＞0.05)；PUF评分分别为25.20±1.81、19.95±2.01、20.80±3.01,第1天与第12、22天比较差异均有统计学意义(P＜0.05),第12天与第22天比较差异无统计学意义(P＞0.05).7例绝经患者的O'Leary-Sant评分和PUF评分的平均值均低于未绝经患者,差异均有统计学意义(P＜0.05).本组58例中,子宫肌瘤、乳腺增生、卵巢囊肿、子宫内膜异位症的发病率分别为48.3％(28/58)、41.4％(24/58)、5.2％(3/58)、13.8％(8/58),均高于国内一般人群的发病率30.0％、40.0％、0.3％、7.0％,除乳腺增生外,其他3种疾病的发病率与国内一般人群比较差异均有统计学意义(P＜0.05). 结论 女性IC患者的尿频、尿急和膀胱疼痛等症状主要在月经期加重,且未绝经患者的症状比绝经患者严重；女性IC患者伴发性激素失调病的发病率高于国内一般人群,说明性激素失调可能是女性IC的致病因素之一.%Objective To Investigate the clinical relationship between the interstitial cystitis and female hormone imbalance.Methods A retrospective analysis of 58 cases of IC female patients in our hospital from January 2006 to April 2012.The patients' age ranged from 21 to 76 years,and the average age was 40.2±12.4 years old.The suffering time of disease ranged from 9 to 120 months,and the average duration was 64.3±55.7 months.At the 1st,12th,22th day of the menstrual cycle,the O'Leary-Sant and PUF questionnaires were used to score,in order to analyze the relationship between IC symptoms and the menstrual cycle.The symptoms scores between postmenopausal patients and No menopause patients were compared.At the same time,the medical records and follow-ups were reviewed for all patients.Results 51 cases of IC premenopausal female patients suffered more urinary frequency,urgency,and bladder pain during the menstrual period.The proportion respectively were 54.9 ％ (28/51),60.8％ (31/51).The O'Leary-Sant scores of the 1st day were more significant difference than the12th and the 22th day (P＜0.05),but there was no significant difference between the 12th day and the 22th day (P＞0.05).The PUF scores of the 1st day were significant different than the 12th and the 22th day (P＜0.05),but there was no significant difference between the 12th day and the 22th day (P＞0.05).The average scores of O'Leary-Sant and PUF in 7 postmenopausal patients were statistically significant lower than non-menopausal patients (P＜0.05).The incidence of 58 cases with uterine fibroids,breast hyperplasia,ovarian cysts,endometriosis (48.3％,41.4％,5.2％,13.8％) were higher than the average persons (P=0.001,0.460,0.001,0.048),which were significantly higher than the incidence of the general population (30.0％,40.0％,0.3％,7.0％) excepting breast hyperplasia.Conclusions The symptoms of urinary frequency,urgency,and bladder pain in IC patients were more serious during the menstrual period than the other periods.The symptoms of the non-postmenopausal patients were more serious than the postmenopausal patients.The incidence of IC patients associated with hormone imbalance diseases was higher than the general persons,indicating that the fluctuation of female hormone level was likely to be one cause of IC onset.