Interstitial Cystitis/Painful Bladder Syndrome and Associated Medical Conditions With an Emphasis on Irritable Bowel Syndrome, Fibromyalgia and Chronic Fatigue Syndrome
Interstitial Cystitis/Painful Bladder Syndrome and Associated Medical Conditions With an Emphasis on Irritable Bowel Syndrome, Fibromyalgia and Chronic Fatigue Syndrome
复制标题
DOI：
10.1016/j.juro.2010.06.005
复制
发表时间：
2010-10-01
影响因子：
6.6
通讯作者：
Nordling, Jorgen
中科院分区：
文献类型：
--
作者：
Nickel, J. Curtis;Tripp, Dean A.;Nordling, Jorgen
目的：我们描述并比较了间质性膀胱炎/膀胱疼痛综合征与对照组之间临床表型相关性的影响，这些表型与潜在相关疾病，特别是肠易激综合征、纤维肌痛和慢性疲劳综合征有关。间质性膀胱炎/膀胱疼痛综合征女性患者和无间质性膀胱炎/膀胱疼痛综合征的对照女性患者膀胱疼痛综合征完成了一系列生物心理社会表型调查问卷，包括人口统计学/病史表，自我报告的相关疾病史，和10份针对症状的有效问卷，结果：205例间质性膀胱炎/膀胱疼痛综合征患者和117例年龄匹配的对照者完成了问卷调查。与对照组相比，间质性膀胱炎/膀胱疼痛综合征患者自我报告的相关疾病诊断的患病率为肠易激综合征38.6% vs 5.2%，纤维肌痛17.7% vs 2.6%，慢性疲劳综合征9.5% vs 1.7%（均p <0.001）。在间质性膀胱炎/膀胱疼痛综合征队列中，50.3%的患者未报告其他相关疾病，24.4%的患者仅患有间质性膀胱炎/膀胱疼痛综合征+肠易激综合征，2.5%的患者仅患有间质性膀胱炎/膀胱疼痛综合征+纤维肌痛，1.5%的患者仅患有间质性膀胱炎/膀胱疼痛综合征+慢性疲劳综合征，而20.2%的患者患有多种相关疾病。随着相关疾病数量的增加（即局部、区域、全身），疼痛、压力、抑郁和睡眠障碍增加，而社会支持、性功能和生活质量恶化。焦虑和灾难化在所有组中仍然增加。症状持续时间与这种明显的表型progress.Conclusions：肠易激综合征，纤维肌痛和慢性疲劳综合征是更普遍的间质性膀胱炎/膀胱疼痛综合征患者比无症状的对照组，并导致显着的影响。基于重叠综合征模式的鉴定，至少有3种不同的临床表型。仍有待纵向研究证实的一个建议是，随着时间的推移，可能会从器官中心发展为区域性疼痛综合征，最终发展为全身性疼痛综合征，症状严重程度不断加重，认知和心理社会参数恶化。
Purpose: We characterized and compared the impact of clinical phenotypic associations between interstitial cystitis/painful bladder syndrome and controls in relation to potentially related conditions, particularly irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome.Materials and Methods: Female patients with interstitial cystitis/painful bladder syndrome and controls with no interstitial cystitis/painful bladder syndrome completed a biopsychosocial phenotyping questionnaire battery which included demographics/history form, self-reported history of associated conditions, and 10 validated questionnaires focused on symptoms, suffering/coping and behavioral/social factors.Results: Questionnaires were completed by 205 patients with interstitial cystitis/painful bladder syndrome and 117 controls matched for age. Prevalence of selfreported associated condition diagnosis in interstitial cystitis/painful bladder syndrome vs controls was irritable bowel syndrome 38.6% vs 5.2%, fibromyalgia 17.7% vs 2.6% and chronic fatigue syndrome 9.5% vs 1.7% (all p < 0.001). In the interstitial cystitis/painful bladder syndrome cohort 50.3% reported no other associated condition, 24.4% had interstitial cystitis/painful bladder syndrome + irritable bowel syndrome only, 2.5% had interstitial cystitis/painful bladder syndrome + fibromyalgia only, 1.5% had interstitial cystitis/painful bladder syndrome + chronic fatigue syndrome only, while 20.2% had multiple associated conditions. As the number of associated conditions increased (ie localized, regional, systemic), pain, stress, depression and sleep disturbance increased while social support, sexual functioning and quality of life deteriorated. Anxiety and catastrophizing remained increased in all groups. Symptom duration was associated with this apparent phenotypic progression.Conclusions: Irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome are more prevalent in patients with interstitial cystitis/painful bladder syndrome than in asymptomatic control subjects, and result in significant impact. There are at least 3 distinct clinical phenotypes based on identification of overlapping syndrome patterns. A suggestion that remains to be proven with longitudinal studies is that there may be progression over time from an organ centric to a regional and finally to a systemic pain syndrome with progression of symptom severity, and deterioration of cognitive and psychosocial parameters.