Sarma Aruna V, Jacobsen Steven J, Girman Cynthia J, Jacobson Debra J, Roberts Rosebud O, Rhodes Thomas, Lieber Michael
Department of Urology and Epidemiology, University of Michigan, Ann Abor, USA.
J Urol. 2002 Oct;168(4 Pt 1):1446-52. doi: 10.1016/S0022-5347(05)64471-0.
Care for men with benign prostatic hyperplasia consumes a sizable amount of health care resources, which is largely driven by bother from lower urinary tract symptoms. While cross-sectional studies have demonstrated a strong correlation between frequency of symptoms and associated bother, there are few longitudinal data demonstrating how these track together.
In 1989, 2,115 white men between 40 and 79 years old were recruited from a random sample of the Olmsted County population. These men completed a self-administered questionnaire that assessed lower urinary tract symptom severity and associated bother with questions similar to those in the American Urological Association Symptom Index. Questionnaires were completed biennially thereafter through 1996.
Annualized changes in symptom score increased from a median of 0.02 per year (25th, 75th percentile -0.35, 0.60) for men in their forties to 0.43 (-0.12, 1.16) for men in their sixties. The median change in bother scores was 0 (-0.30, 0.29) across all ages. The correlation between longitudinal symptom score slopes and bother score slopes was 0.55 (p <0.001) overall and did not differ substantively across age.
These results demonstrate that there is a great deal of variability between individuals in the amount of longitudinal change in lower urinary tract symptom severity and bother. While for bother, there is little change across individuals on average, within individual frequency and bother track together fairly closely. However, there remain some men with increases in frequency who do not report similar increases in bother, possibly representing some component of adaptation or acceptance of worsening symptom severity with age.
对良性前列腺增生男性的护理消耗了大量医疗资源，这在很大程度上是由下尿路症状带来的困扰所驱动的。虽然横断面研究已证明症状频率与相关困扰之间存在很强的相关性，但很少有纵向数据表明它们是如何共同变化的。
1989年，从奥尔姆斯特德县人群的随机样本中招募了2115名年龄在40至79岁之间的白人男性。这些男性完成了一份自我管理的问卷，该问卷通过与美国泌尿外科学会症状指数中类似的问题评估下尿路症状的严重程度及相关困扰。此后每两年完成一次问卷，直至1996年。
症状评分的年化变化从四十多岁男性的每年中位数0.02（第25、75百分位数为-0.35，0.60）增加到六十多岁男性的0.43（-0.12，1.16）。所有年龄段困扰评分的中位数变化为0（-0.30，0.29）。纵向症状评分斜率与困扰评分斜率之间的总体相关性为0.55（p<0.001），且在各年龄组之间无实质性差异。
这些结果表明，个体在下尿路症状严重程度和困扰的纵向变化量方面存在很大差异。虽然困扰方面，个体平均变化不大，但个体内症状频率和困扰变化相当紧密地跟踪在一起。然而，仍有一些症状频率增加的男性并未报告类似的困扰增加，这可能代表了随着年龄增长对症状严重程度恶化的某种适应或接受成分。
