CAJ | 학술논문

目的探讨合并疾病的良性前列腺增生(BPH)患者下尿路症状对生活质量(QOL)的影响. 方法对确诊BPH的患者采取问卷调查,国际前列腺症状评分(IPSS)评价下尿路症状,QOL评分以评价生活质量,B超测定前列腺体积、膀胱残余尿量,尿流动力学检查测定最大尿流率,用Charlson合并症指数(CCI)对合并疾病进行评分并把患者分为无、低和高合并症组.分别比较3组患者的IPSS评分、QOL评分及相关指标,并分析影响IPSS、QOL评分的因素. 结果 193例BPH并存合并症的患者171例(88.6％),无合并症的患者22例(11.4％).在合并症中,心血管疾病161例(94.2％)、糖尿病78例(45.6％)、脑血管系统疾病51例(29.8％)、慢性呼吸系统疾病34例(19.9％)、肝病8例(4.7％)、肿瘤5例(2.9％).高合并症组的IPSS评分及QOL评分高于低合并症组及无合并症组(P＜0.05),最大尿流率高合并症组低于无合并症组(P＜0.05),而组间前列腺体积及膀胱残余尿量则差异无统计学意义(P＞0.05).多元线性回归分析显示,CCI、年龄、前列腺体积与IPSS评分存在线性依存关系(标准化回归系数分别为0.26、0.17、0.24,均P＜0.05),即CCI越高、年龄越大、前列腺体积越大,IPSS评分越高,下尿路症状越严重.CCI、年龄与QOL评分呈线性关系,其标准化回归系数为0.16、0.26(均P＜0.05),即CCI越高、年龄越大,QOL评分越高,生活质量越低.结论合并疾病普遍存在于BPH患者中,且CCI高的BPH患者下尿路症状重,生活质量低.
목적 탐토합병질병적량성전렬선증생(BPH)환자하뇨로증상대생활질량(QOL)적영향. 방법 대학진BPH적환자채취문권조사,국제전렬선증상평분(IPSS)평개하뇨로증상,QOL평분이평개생활질량,B초측정전렬선체적、방광잔여뇨량,뇨류동역학검사측정최대뇨류솔,용Charlson합병증지수(CCI)대합병질병진행평분병파환자분위무、저화고합병증조.분별비교3조환자적IPSS평분、QOL평분급상관지표,병분석영향IPSS、QOL평분적인소. 결과 193례BPH병존합병증적환자171례(88.6％),무합병증적환자22례(11.4％).재합병증중,심혈관질병161례(94.2％)、당뇨병78례(45.6％)、뇌혈관계통질병51례(29.8％)、만성호흡계통질병34례(19.9％)、간병8례(4.7％)、종류5례(2.9％).고합병증조적IPSS평분급QOL평분고우저합병증조급무합병증조(P＜0.05),최대뇨류솔고합병증조저우무합병증조(P＜0.05),이조간전렬선체적급방광잔여뇨량칙차이무통계학의의(P＞0.05).다원선성회귀분석현시,CCI、년령、전렬선체적여IPSS평분존재선성의존관계(표준화회귀계수분별위0.26、0.17、0.24,균P＜0.05),즉CCI월고、년령월대、전렬선체적월대,IPSS평분월고,하뇨로증상월엄중.CCI、년령여QOL평분정선성관계,기표준화회귀계수위0.16、0.26(균P＜0.05),즉CCI월고、년령월대,QOL평분월고,생활질량월저.결론 합병질병보편존재우BPH환자중,차CCI고적BPH환자하뇨로증상중,생활질량저.
Objective To investigate the effects of comorbidity on the severity of lower urinary tract symptoms and quality of life in patients with benign prostate hyperplasia.Methods International prostate symptom score(IPSS) and quality of life(QOL)in patients diagnosed as BPH were assessed by questionnaires.The volumes of prostate and residual urine were detected by type-B ultrasonic.The urine flow rate was determined by urodynamic study.The conditions of comorbidities were investigated by Charlson comorbidity index(CCI).According to CCI,patients were divided into CCI high group,CCI low group and CCI zero group.IPSS,QOL and their related factors were analyzed and compared among the groups.Results A total of 193 patients with BPH were recruited.There were 171 patients with comorbidities.Among these comorbidities,cardiovascular diseases accounted for 88.6 ％ (n =161),diabetes accounted for 45.6 ％ (n =81),cerebrovascular diseases accounted for 29.8％ (n=51),chronic respiratory diseases accounted for 19.9％ (n=34),liver diseases accounted for 4.7％(n=8) and tumors accounted for 2.9％(n=5).The scores of IPSS and QOL were significantly higher in CCI high group than in CCI low group and CCIzero group(both P ＜0.05).The maximum rates of urine flow were significantly higher in CCI high group than in CCI zero group(P＜0.05).There were no significant differences in volume of prostate and residual urine between groups(all P＞0.05).Multiple linear regression analysis revealed that CCI,age,the volume of prostate were positively correlated to IPSS score (standardized regression coefficient were 0.26,0.17,0.24,respectively,all P＜ 0.05).And CCI and age were positively correlated to QOL (standardized regression coefficient were 0.16 and 0.26,both P ＜ 0.05).Conclusions Comorbidities are commonly presented in BPH patients.BPH patients with high CCI have severe lower urinary tract symptoms and lower QOL.