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中文男性慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)中 UPOINT 表型系统的临床应用:一项前瞻性研究。

Clinical utility of the UPOINT phenotype system in Chinese males with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): a prospective study.

机构信息

Department of Urology & Andrology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, Guangdong Provincial Key Laboratory of Urology, Guangzhou, Guangdong Province, China.

出版信息

PLoS One. 2013;8(1):e52044. doi: 10.1371/journal.pone.0052044. Epub 2013 Jan 17.

Abstract

BACKGROUND

Recent data showed that a six-domain UPOINT is a flexible and responsive new classification system that has the clinical applicability in CP/CPPS. However, the utility of UPOINT algorithm in men in China with CP/CPPS has not been comprehensively studied. For international validation and adoption, we evaluated this clinical phenotype system for a large cohort of Chinese CP/CPPS patients and correlated it with patient symptoms and erectile dysfunction (ED). We also investigated the addition of an ED domain in regard to symptom correlation.

METHODS

A total of 389 Chinese males with CP/CPPS were prospectively collected and classified in each domain of the UPOINT system. Symptom severity was measured using the NIH-CPSI and IPSS. The erectile function was evaluated using the IIEF-5. Clinically relevant associations were calculated.

RESULTS

The percentage of patients positive for each domain was 54.0%, 42.1%, 41.9%, 20.8%, 26.7%, and 40.4% for the Urinary, Psychosocial, Organ-specific, Infection, Neurological/systemic, and Tenderness, respectively. There were significant correlations between the number of positive UPOINT domains and total NIH-CPSI (r = 0.706, p<0.001), IPSS (r = 0.682, p<0.001) and IIEF-5 scores (r = 0.631, P = 0.007) in Chinese cohort. Except for patients age, symptom duration was associated with a significantly greater number of positive domains (r = 0.638, P  = 0.005). After adding an ED domain to create a modified UPOINT system, the correlation between the number of phenotypic domains and symptom severity was improved (0.706 to 0.844, p<0.001).

CONCLUSIONS

The clinical applicability of using UPOINT phenotyping system has been validated in the Chinese patients with CP/CPPS. In our cohort, the number of positive domains was also correlated with ED symptoms and the significant association between the number of UPOINT domains and NIH-CPSI scores was further refined by adding a domain for ED. Our findings presented here support the utility of using ED as a stand-alone item in the UPOINT domain.

摘要

背景

最近的数据表明,六域 UPOINT 是一种灵活且响应灵敏的新分类系统,具有 CP/CPPS 的临床适用性。然而,UPOINT 算法在中国 CP/CPPS 男性中的应用尚未得到全面研究。为了进行国际验证和采用,我们对大量中国 CP/CPPS 患者进行了该临床表型系统评估,并将其与患者症状和勃起功能障碍 (ED) 相关联。我们还研究了在症状相关性方面增加 ED 域的效果。

方法

前瞻性收集了 389 名中国男性 CP/CPPS 患者,并按照 UPOINT 系统的每个域进行分类。使用 NIH-CPSI 和 IPSS 测量症状严重程度。使用 IIEF-5 评估勃起功能。计算临床相关关联。

结果

每个域阳性的患者百分比分别为:排尿、心理社会、器官特异性、感染、神经/系统和压痛域为 54.0%、42.1%、41.9%、20.8%、26.7%和 40.4%。UPOINT 域的数量与 NIH-CPSI(r=0.706,p<0.001)、IPSS(r=0.682,p<0.001)和 IIEF-5 评分(r=0.631,P=0.007)之间存在显著相关性。除了患者年龄外,症状持续时间与阳性域的数量显著相关(r=0.638,P=0.005)。在用 ED 域创建改良 UPOINT 系统后,表型域数量与症状严重程度之间的相关性得到改善(0.706 至 0.844,p<0.001)。

结论

UPOINT 表型系统在中国 CP/CPPS 患者中的临床适用性已得到验证。在我们的队列中,阳性域的数量也与 ED 症状相关,通过添加 ED 域,UPOINT 域数量与 NIH-CPSI 评分之间的显著关联得到进一步细化。我们在这里提出的发现支持将 ED 作为 UPOINT 域中的独立项目使用的效用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2149/3547952/3f8a8dc747e9/pone.0052044.g001.jpg

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