›› 2012, Vol. 32 ›› Issue (4): 419-.doi: 10.3969/j.issn.1674-8115.2012.04.011

• 专题报道(排尿功能障碍及盆底重建) • 上一篇    下一篇

上海地区2 410例女性压力性尿失禁流行病学研究

潘家骅, 徐 灵, 吕坚伟, 沙建军, 张连华, 薄隽杰, 冷 静, 刘东明, 黄翼然   

  1. 上海交通大学 医学院附属仁济医院泌尿外科 |上海交通大学尿失禁及盆底重建诊治中心, 上海 200001
  • 出版日期:2012-04-28 发布日期:2012-04-27
  • 通讯作者: 冷 静, 电子信箱: lengjing88@yahoo.com.cn。
  • 作者简介:潘家骅(1980—), 男, 住院医师, 硕士;电子信箱: panjiahua@126.com。

Epidemiological study on stress urinary incontinence in 2 410 women in Shanghai

PAN Jia-hua, XU Ling, LV Jian-wei, SHA Jian-jun, ZHANG Lian-hua, BO Juan-jie, LENG Jing, LIU Dong-ming, HUANG Yi-ran   

  1. Department of Urology, Renji Hospital, Center of Urinary Incontinence and Pelvic Reconstruction, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China
  • Online:2012-04-28 Published:2012-04-27

摘要:

目的 研究上海地区女性压力性尿失禁(SUI)的流行病学特点,寻找其高危因素,为临床诊治提供参考。方法 采用多级抽样法将上海地区10区县2 600例28~89岁女性作为调查对象,包括工人、教师、职员、医护人员和公务员等职业。调查问卷共发放2 600份,回收有效问卷2 410份,应答率为92.7%。问卷设计包括年龄、职业、身高、体质量、内科并发症、生育情况和流产次数,并整合生活质量量表(QOL)及国际前列腺症状评分(IPSS)。结果 2 410例中急迫性尿失禁患者288例(11.9%),混合型尿失禁患者334例(13.8%),单纯SUI患者699例(29.0%),无尿失禁患者1 089例。699例SUI女性平均年龄(54.4±12)岁,非SUI女性平均年龄(48.4±11)岁(P=0.000)。SUI女性平均体质量指数(BMI)23.2±4.0,非SUI女性平均BMI 22.3±3.1(P=0.000)。SUI女性合并代谢综合征共403例,非SUI女性合并代谢综合征352例(χ2=111.97,P=0.000)。SUI女性合并慢性便秘共491例,无尿失禁患者合并慢性便秘共322例(χ2=284.07,P=0.000)。SUI女性合并慢性支气管炎共213例,无尿失禁患者合并慢性支气管炎共174例(χ2=52.74,P=0.000)。生育与否与SUI发生率呈显著相关(χ2=29.81,P=0.000);多次分娩较单次分娩SUI发病率显著增高(χ2=13.68,P=0.000)。SUI女性平均QOL评分10.97分,平均IPSS为3.76分,两者显著相关(P=0.000);且SUI女性年龄与QOL评分呈显著相关(P=0.000)。结论 SUI已成为我国中老年女性重要的排尿障碍性疾病,其发病率呈逐年增长态势。SUI的高发年龄呈双峰型,主要发病年龄段分别为40~59岁及80岁以上。发病率与年龄呈显著相关。肥胖、合并代谢综合征、慢性便秘、慢性支气管炎、生育和多次分娩均是SUI发病的高危因素。在SUI患者中,除漏尿外下尿路症状亦是影响其生活质量的重要因素,选择性M受体阻滞剂的应用可能对改善其生活质量有益。

关键词: 流行病学调查, 压力性尿失禁, 生活质量评分, 高危因素

Abstract:

Objective To investigate the epidemiological characteristics of female stress urinary incontinence (SUI) in Shanghai, and explore the risk factors for clinical reference. Methods Two thousand and six hundred women aged between 28 and 89 years from 10 districts in Shanghai were selected with multi-stage sampling method, which included workers, teachers, employees, medical staffs and civil servants. A total of 2 600 questionnaires were distributed, and 2 410 valid questionnaires were recovered, with the response rate of 92.7%. The questionnaire design included age, occupation, height, weight, medical co-mobidities, number of delivery, times of abortion, quality of life scale (QOL) score and International Prostate Symptom Score (IPSS). Results Of the 2 410 women, there were 288 women (11.9%) with urge urinary incontinence, 334 (13.8%) women with mixed urinary incontinence and 699 women (29.0%) with pure SUI, and 1 089 women did not have urinary incontinence. The average age of 699 women with SUI was (54.4±12) years, and that of women without SUI was (48.4±11) years (P=0.000). The average body mass index (BMI) of women with SUI was 23.2±4.0, and that of women without SUI was 22.3±3.1 (P=0.000). Four hundred and three women with SUI had metabolic syndrome, and 352 women without SUI had metabolic syndrome (χ2=111.97, P=0.000). Chronic constipation was found in 491 women with SUI, and 322 women without SUI had chronic constipation (χ2=284.07, P=0.000). Two hundred and thirteen women with SUI had chronic bronchitis, while 174 women without SUI had chronic bronchitis (χ2=52.74, P=0.000). The incidence of SUI was significantly related to the history of delivery (χ2=29.81, P=0.000), and the incidence of SUI in women with multiple delivery was significantly higher than that in women with single delivery (χ2=13.68, P=0.000). The average QOL score was 10.97, and the average IPSS was 3.76 in women with SUI, and there was significant correlation between them (P=0.000). The QOL score was significantly related to age in women with SUI (P=0.000). Conclusion SUI has become an important voiding dysfunction disorder in elder women in China, with increasingly higher incidence over years. Forty to 59 years and over 80 years are two main age periods with higher incidence. The incidence is significantly related to age. Obesity, metabolic syndrome, chronic constipation, chronic bronchitis and multiple delivery are risk factors for SUI. In patients with SUI, symptoms of lower urinary tract are important factors affecting quality of life in addition to urine leakage. Selective M receptor blockers may be useful to improve their quality of life.

Key words: epidemiological study, stress urinary incontinence, quality of life, high risk factors