Groen S, lagro-Janssen A L M
Universitair Medisch Centrum St Radboud, vakgroep Huisartsgeneeskunde, Vrouwenstudies Geneeskunde, Huispost 229 HSV, Postbus 9109, 6500 HB, Nijmegen.
Ned Tijdschr Geneeskd. 2005 May 7;149(19):1048-51.
To investigate the natural history of recurrent urinary tract infections in women of childbearing age and to gain insight into their consequences and the ideas of the patients.
Historical cohort-study and interviews with patients.
All non-pregnant women in the age-range 15-49 years who had had > or =2 urinary tract infections in one year in the period 1990-1994 were selected with the aid of the 'Continuous morbidity registration' (CMR) from four general practices in Nijmegen, The Netherlands. The patients' files were used for supplementary information. The risk of recurrence was calculated by the Kaplan-Meier method. Patients between the ages of 15 and 35 who had had > or =2 urinary tract infections in one year in the period 2002-2003 were interviewed.
Of the 115 women in the CMR-study group, 70 (61%) were younger than 30 years. The median duration of follow-up was 10.0 years. The risk of a new recurrence within one year was 56%; the chance of remaining free of recurrences for two years was 33%. The 115 patients underwent a total of 630 urinary tract infections during the study period; an antibiotic was prescribed every time. 2 of the 115 patients developed pyelitis/pyelonephritis. An underlying abnormality was found in one of the 12 patients that were referred. Of the 21 women that were interviewed, 8 (38%) stayed away from school or work during the infection, depending on the symptoms. Of the 18 women that were sexually active, 13 (72%) did not want to have sex during the infection. 10 of the 21 women (48%) were concerned about possible complications. A decreased resistance, cold on the bladder, stress, menstruation and improper vaginal hygiene were most frequently mentioned by the women as the cause ofthe urinary tract infections. When women with recurrent urinary tract infections consult a general practitioner, the latter can discuss their unjustified concerns and attributions.
调查育龄期女性复发性尿路感染的自然病史，并深入了解其后果及患者的想法。
历史性队列研究及患者访谈。
借助“连续发病登记”（CMR），从荷兰奈梅亨的四家全科诊所选取了1990 - 1994年期间一年内有≥2次尿路感染的所有15 - 49岁非妊娠女性。患者档案用于补充信息。复发风险通过Kaplan - Meier方法计算。对2002 - 2003年期间一年内有≥2次尿路感染的15至35岁患者进行了访谈。
CMR研究组的115名女性中，70名（61%）年龄小于30岁。中位随访时间为10.0年。一年内新复发的风险为56%；两年内无复发的几率为33%。在研究期间，115名患者共发生630次尿路感染；每次均开具了抗生素。115名患者中有2名发生了肾盂炎/肾盂肾炎。在转诊的12名患者中有1名发现了潜在异常。在接受访谈的21名女性中，8名（38%）根据症状在感染期间请假未上学或工作。在18名有性生活的女性中，13名（72%）在感染期间不想进行性行为。21名女性中有10名（48%）担心可能出现并发症。女性最常提到抵抗力下降、膀胱受凉、压力、月经和阴道卫生不当是尿路感染的原因。当复发性尿路感染的女性咨询全科医生时，后者可以讨论她们不合理的担忧和归因。
