Evidence-based criteria for pain of interstitial cystitis/painful bladder syndrome in women
Evidence-based criteria for pain of interstitial cystitis/painful bladder syndrome in women
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DOI：
10.1016/j.urology.2007.10.062
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发表时间：
2008-03-01
期刊：
影响因子：
2.1
通讯作者：
Greenberg, Patty
中科院分区：
文献类型：
--
作者：
Warren, John W.;Brown, Jessica;Greenberg, Patty
目的 间质性膀胱炎/膀胱疼痛综合征 (IC/PBS) 没有可用的诊断体征、泌尿系统检查结果或实验室检查。其诊断是根据症状和排除类似疾病来确定的。我们假设某些疼痛特征是诊断 IC/PBS 的敏感标准。 方法 在 2004 年至 2006 年为病例对照研究“间质性膀胱炎之前的事件”招募的新近发作 IC/PBS 的女性中，我们确定了每位患者疼痛的位置，并以非主导方式询问 17 种不同经历（标准）对疼痛的影响。我们确定了一组标准，描述了间质性膀胱炎研究中最多的患者数量。在对 1993 年至 1997 年由其他人招募的另一个队列（间质性膀胱炎数据库）进行的二次分析中，我们确定了按照这些相同标准捕获的患者比例。 结果 在间质性膀胱炎研究之前的事件中，156 名患者中有 151 名 (97%) 报告疼痛因某种食物或饮料而恶化和/或因膀胱充盈而恶化和/或因排尿而改善。这是唯一直接适用于膀胱的三个标准。同样的三个标准描述了间质性膀胱炎数据库中 270 名“肯定”患有 IC/PBS 的女性中的 262 名 (97%) 的疼痛。结论 在一个 IC/PBS 患者组中产生并在另一组中进行测试的假设——疼痛因某些食物或饮料而恶化和/或因膀胱充盈而恶化和/或因排尿而改善——每个队列中 97% 的 IC/PBS 患者描述了这一假设。这个三元组可能描述了 IC/PBS 的痛苦，并有助于敏感病例的定义。估计特异性有待与具有类似症状的其他疾病进行比较。
OBJECTIVES No diagnostic physical signs, urologic findings, or laboratory tests are available for interstitial cystitis/painful bladder syndrome (IC/PBS). Its diagnosis is determined by symptoms and the exclusion of mimicking diseases. We hypothesized that certain pain characteristics are sensitive criteria for diagnosing IC/PBS.METHODS In women with recent-onset IC/PBS recruited in 2004 to 2006 for the case-control study, "Events Preceding Interstitial Cystitis," we identified the locations of each patient's pain and in a nonleading way asked about the effects of 17 different experiences (criteria) on the pain. We identified a set of criteria that described the largest number of patients in the Events Preceding Interstitial Cystitis study. In a secondary analysis of another cohort recruited by others in 1993 to 1997, the Interstitial Cystitis Database, we determined the proportion of patients captured by these same criteria.RESULTS In the Events Preceding Interstitial Cystitis study, pain that worsened with a certain food or drink and/or worsened with bladder filling and/or improved with urination was reported by 151 (97%) of 156 patients. These were the only three criteria that applied directly to the bladder. The same three criteria described the pain of 262 (97%) of 270 women in the Interstitial Cystitis Database who "definitely" had IC/PBS.CONCLUSIONS An hypothesis generated in one IC/PBS patient group and tested in another-pain that worsened with certain food or drink and/or worsened with bladder filling and/or improved with urination-was described by 97% of the patients with IC/PBS in each cohort. This triad might describe the pain of IC/PBS and contribute to a sensitive case definition. Estimating specificity awaits comparison with other diseases with similar symptoms.