Greenberg Patty, Tracy J Kathleen, Meyer Walter A, Yates Teresa, Diggs Christina, Warren John W
Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
BJU Int. 2007 Sep;100(3):599-602; discussion 602. doi: 10.1111/j.1464-410X.2007.06989.x. Epub 2007 Jun 2.
To assess how many patients with interstitial cystitis/painful bladder syndrome (IC/PBlS) obtain medical care soon after symptom onset, and to determine how these patients differ from those who have medical care later.
In a risk-factor study of IC/PBlS, we recruited women with IC/PBlS symptoms of < or =12 months' duration and carefully identified the onset date, first medical encounter and early clinical findings.
Of 138 women with IC/PBlS for < or =12 months, 49% sought medical care within 7 days and another 31% within 4 weeks. These patients had no easier access to medical care but rather experienced symptoms differently, with more evidence for discomfort and inflammation. However, subsequently they did not differ from those with more gradual onset in features indicative of IC/PBlS, i.e. Hunner's ulcers, petechial haemorrhages, symptoms, medications, or quality of life.
A shorter time to the first medical encounter was not a function of greater access to medical care but instead was associated with more discomfort and evidence of inflammation, as distinct from those with more gradual onset. The 6-month follow-up of both groups indicated that no significant differences in IC/PBlS symptoms persisted. A careful study of rapid-onset IC/PBlS might provide clues to the pathogenesis of this enigmatic disease.
评估有多少间质性膀胱炎/膀胱疼痛综合征(IC/PBlS)患者在症状出现后不久就获得了医疗护理,并确定这些患者与那些较晚获得医疗护理的患者有何不同。
在一项关于IC/PBlS的危险因素研究中,我们招募了病程≤12个月的IC/PBlS症状女性患者,并仔细确定了发病日期、首次就医情况及早期临床发现。
在138例病程≤12个月的IC/PBlS女性患者中,49%在7天内寻求医疗护理,另外31%在4周内寻求医疗护理。这些患者获得医疗护理的途径并非更便捷,而是症状体验不同,有更多不适和炎症的证据。然而,随后在IC/PBlS的特征方面,即Hunner溃疡、瘀点出血、症状、用药或生活质量方面,他们与起病较缓的患者并无差异。
首次就医时间较短并非因为更容易获得医疗护理,而是与更多不适和炎症证据相关,这与起病较缓的患者不同。两组患者6个月的随访表明,IC/PBlS症状持续存在无显著差异。对快速起病的IC/PBlS进行仔细研究可能为这种神秘疾病的发病机制提供线索。