Fu Zenghui, Jin Yan, Lin Zaihong, Li Zhichao, Liu Songtao, Liu Yang, Yu Huili
Department of Neurology, Third Affiliated Hospital of Qiqihar Medical University, Qiqihar Heilongjiang 161002.
Department of Urology, Third Affiliated Hospital of Qiqihar Medical University, Qiqihar Heilongjiang 161002.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024;49(9):1412-1420. doi: 10.11817/j.issn.1672-7347.2024.240059.
Interstitial cystitis/bladder pain syndrome (IC/BPS) and migraine are both chronic pain syndromes with similarities in pathophysiology and clinical presentation. This study aims to investigate the clinical characteristics of IC/BPS patients with comorbid migraine.
A retrospective analysis was conducted on the clinical data of 303 IC/BPS patients treated at the Second and Third Affiliated Hospitals of Qiqihar Medical University from January 2019 to December 2023. Disease severity, bladder pain and/or headache intensity, anxiety, depression, sleep quality, somatic symptoms, and quality of life were assessed using the O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI), Numerical Rating Scale (NRS), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), Self-Rating Somatic Symptom Scale (SSS), and Visual Analogue Scales (VAS) for quality of life. Serum inflammatory cytokines [interleukin-1β (IL-1β), interleukin-6 (IL-6)] and pain mediators [prostaglandin E2 (PGE2), substance P (SP)] were measured using enzyme-linked immunosorbent assay (ELISA).
Among the 303 IC/BPS patients, 87 (28.71%) had comorbid migraine. Compared to IC/BPS patients without migraine, those with migraine had a longer IC/BPS duration, higher ICSI scores, elevated bladder pain NRS, GAD-7, PHQ-9, PSQI, SSS, VAS scores for quality of life, and higher serum levels of IL-1β, IL-6, PGE2, and SP, along with fewer weekly exercise sessions (all <0.05). Among the 87 IC/BPS patients with migraine, the 39 patients with severe IC/BPS had higher headache frequency, longer headache duration, and significantly higher headache NRS, bladder pain NRS, GAD-7, PSQI, SSS, VAS scores for quality of life, and serum levels of IL-1β, IL-6, PGE2, and SP compared to the 48 patients with mild-to-moderate IC/BPS (all <0.05). In IC/BPS patients with migraine, ICSI scores were positively correlated with headache NRS (=2.072, =0.032), headache frequency (=2.184, =0.028), headache duration (=1.843, =0.041), bladder pain NRS (=2.295, =0.023), GAD-7 scores (=2.210, =0.025), SSS scores (=3.159, =0.009), and VAS scores for quality of life (=2.891, =0.013) but not with PSQI scores (=1.515, =0.070).
Patients with IC/BPS and comorbid migraine exhibit more severe clinical and psychological symptoms. The severity of IC/BPS symptoms is associated with migraine severity.
间质性膀胱炎/膀胱疼痛综合征（IC/BPS）和偏头痛均为慢性疼痛综合征，在病理生理学和临床表现上存在相似之处。本研究旨在调查合并偏头痛的IC/BPS患者的临床特征。
对2019年1月至2023年12月在齐齐哈尔医学院附属第二医院和附属第三医院接受治疗的303例IC/BPS患者的临床资料进行回顾性分析。使用奥利里-桑特间质性膀胱炎症状指数（ICSI）、数字评分量表（NRS）、广泛性焦虑障碍量表-7（GAD-7）、患者健康问卷-9（PHQ-9）、匹兹堡睡眠质量指数（PSQI）、自评躯体症状量表（SSS）和生活质量视觉模拟量表（VAS）评估疾病严重程度、膀胱疼痛和/或头痛强度、焦虑、抑郁、睡眠质量、躯体症状和生活质量。采用酶联免疫吸附测定（ELISA）法检测血清炎症细胞因子[白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）]和疼痛介质[前列腺素E2（PGE2）、P物质（SP）]。
在303例IC/BPS患者中，87例（28.71%）合并偏头痛。与无偏头痛的IC/BPS患者相比，合并偏头痛的患者IC/BPS病程更长，ICSI评分更高，膀胱疼痛NRS、GAD-7、PHQ-9、PSQI、SSS、生活质量VAS评分更高，血清IL-1β、IL-6、PGE2和SP水平更高，每周锻炼次数更少（均P<0.05）。在87例合并偏头痛的IC/BPS患者中，39例重度IC/BPS患者的头痛频率更高、头痛持续时间更长，头痛NRS、膀胱疼痛NRS、GAD-7、PSQI、SSS、生活质量VAS评分及血清IL-1β、IL-6、PGE2和SP水平均显著高于48例轻至中度IC/BPS患者（均P<0.05）。在合并偏头痛的IC/BPS患者中，ICSI评分与头痛NRS（r=2.072，P=0.032）、头痛频率（r=2.184，P=0.028）、头痛持续时间（r=1.843，P=0.041）、膀胱疼痛NRS（r=2.295，P=0.023）、GAD-7评分（r=2.210，P=0.025）、SSS评分（r=3.159，P=0.009）及生活质量VAS评分（r=2.891，P=0.013）呈正相关，但与PSQI评分（r=1.515，P=0.070）无关。
IC/BPS合并偏头痛的患者表现出更严重的临床和心理症状。IC/BPS症状的严重程度与偏头痛的严重程度相关。
