慢性非泌尿系统相关躯体综合征与泌尿系统慢性盆腔疼痛综合征症状严重程度之间的关系：MAPP研究的基线评估
Relationship between chronic nonurological associated somatic syndromes and symptom severity in urological chronic pelvic pain syndromes: baseline evaluation of the MAPP study.
作者信息
Krieger John N, Stephens Alisa J, Landis J Richard, Clemens J Quentin, Kreder Karl, Lai H Henry, Afari Niloofar, Rodríguez Larissa, Schaeffer Anthony, Mackey Sean, Andriole Gerald L, Williams David A
机构信息
Department of Urology, University of Washington, Seattle, Washington.
Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
出版信息
J Urol. 2015 Apr;193(4):1254-62. doi: 10.1016/j.juro.2014.10.086. Epub 2014 Oct 22.
PURPOSE
We used MAPP data to identify participants with urological chronic pelvic pain syndromes only or a chronic functional nonurological associated somatic syndrome in addition to urological chronic pelvic pain syndromes. We characterized these 2 subgroups and explored them using 3 criteria, including 1) MAPP eligibility criteria, 2) self-reported medical history or 3) RICE criteria.
MATERIALS AND METHODS
Self-reported cross-sectional data were collected on men and women with urological chronic pelvic pain syndromes, including predominant symptoms, symptom duration and severity, nonurological associated somatic syndrome symptoms and psychosocial factors.
RESULTS
Of 424 participants with urological chronic pelvic pain syndromes 162 (38%) had a nonurological associated somatic syndrome, including irritable bowel syndrome in 93 (22%), fibromyalgia in 15 (4%), chronic fatigue syndrome in 13 (3%) and multiple syndromes in 41 (10%). Of 233 females 103 (44%) had a nonurological associated somatic syndrome compared to 59 of 191 males (31%) (p = 0.006). Participants with a nonurological associated somatic syndrome had more severe urological symptoms and more frequent depression and anxiety. Of 424 participants 228 (54%) met RICE criteria. Of 228 RICE positive participants 108 (47%) had a nonurological associated somatic syndrome compared to 54 of 203 RICE negative patients (28%) with a nonurological associated somatic syndrome (p < 0.001).
CONCLUSIONS
Nonurological associated somatic syndromes represent important clinical characteristics of urological chronic pelvic pain syndromes. Participants with a nonurological associated somatic syndrome have more severe symptoms, longer duration and higher rates of depression and anxiety. RICE positive patients are more likely to have a nonurological associated somatic syndrome and more severe symptoms. Because nonurological associated somatic syndromes are more common in women, future studies must account for this potential confounding factor in urological chronic pelvic pain syndromes.
目的
我们使用MAPP数据来识别仅患有泌尿外科慢性盆腔疼痛综合征的参与者，或除泌尿外科慢性盆腔疼痛综合征外还患有慢性功能性非泌尿外科相关躯体综合征的参与者。我们对这两个亚组进行了特征描述，并使用3项标准对其进行探索，包括1）MAPP纳入标准、2）自我报告的病史或3）RICE标准。
材料与方法
收集了患有泌尿外科慢性盆腔疼痛综合征的男性和女性的自我报告横断面数据，包括主要症状、症状持续时间和严重程度、非泌尿外科相关躯体综合征症状和心理社会因素。
结果
在424名患有泌尿外科慢性盆腔疼痛综合征的参与者中，162名（38%）患有非泌尿外科相关躯体综合征，其中93名（22%）患有肠易激综合征，15名（4%）患有纤维肌痛，13名（3%）患有慢性疲劳综合征，41名（10%）患有多种综合征。在233名女性中，103名（44%）患有非泌尿外科相关躯体综合征，而在191名男性中，这一比例为59名（31%）（p = 0.006）。患有非泌尿外科相关躯体综合征的参与者有更严重的泌尿系统症状，以及更频繁的抑郁和焦虑。在424名参与者中，228名（54%）符合RICE标准。在228名RICE阳性参与者中，108名（47%）患有非泌尿外科相关躯体综合征，而在203名RICE阴性患者中，这一比例为54名（28%）患有非泌尿外科相关躯体综合征（p < 0.001）。
结论
非泌尿外科相关躯体综合征是泌尿外科慢性盆腔疼痛综合征的重要临床特征。患有非泌尿外科相关躯体综合征的参与者症状更严重、病程更长，抑郁和焦虑发生率更高。RICE阳性患者更有可能患有非泌尿外科相关躯体综合征且症状更严重。由于非泌尿外科相关躯体综合征在女性中更为常见，未来的研究必须考虑到这一潜在的混杂因素对泌尿外科慢性盆腔疼痛综合征的影响。
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