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中華民國泌尿科醫學會雜誌

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篇名 Lower Urinary Tract Symptoms in Women with Systemic Lupus Erythematosus
卷期 11:4
並列篇名 紅斑性狼瘡患者之下泌尿道症狀研究
作者 李偉嘉李光倫陳茂源陳正言陳淳余宏政
頁次 161-165
關鍵字 紅斑性狼瘡下泌尿道症狀國際前列腺症狀量表Systemic lupus etrythemaosuslower urinary tract symptomsIPSSTSCI
出刊日期 200012

中文摘要

研究目的:紅斑性狼瘡是一腫可以同時侵犯多重器官並且具有許多臨床表徵與檢驗特色的疾病。然而,在已知的文獻中卻很少提及紅斑性狼瘡侵犯膀胱的情形。我們進行這個實驗的目的,就是要了解紅斑性狼瘡女性患者的下泌尿道症狀。材料與方法:從1999年10月到2000年6月,我們針對145名於台大風濕免疫科治療之紅斑性狼瘡患者進行前瞻性的研究。每位病人都接受了詳細的問卷調查,其中包含國際前列腺症狀評分(IPSS),以及紅斑性狼瘡的臨床病史。更進一步地,我們將症狀積分與疾病嚴重程度進行相關係數分析。我們是根據疾病的臨床表現與實驗檢查數據的異常來決定紅斑性狼瘡疾病活性指數(SLEDAI),由此決定疾病的嚴重程度性。最後我們收集由177名年齡配對的健康婦女組成的症狀積分作為對照組。結果:在總症狀積分(6.24±0.56 vs.4.26±0.36)、刺激性症狀積分(3.71±0.32 vs. 2.88±0.22)、阻塞性症狀積分(2.53±0.33 vs.1.38±0.19)中,紅斑性狼瘡患者要比對照組得分較高。同時這些症狀積分與疾病活性成正相關(r=0.28,p<0.001),但與發病長短無關。在全部的病人中,有45名(31.0%)的國際前列腺症狀評分(IPSS)大於七分。此外,將下泌尿道症狀歸咎於紅斑性狼瘡發作的病患,其泌尿道症狀積分較其他病友較高。而有38名患者(26.2%)非常不滿意他們的排尿情形。結論:我們的研究暗示著一定數量的女性紅斑性狼瘡病患為程度不等的排尿障礙所苦,此一情況與疾病活性呈現有意義之關聯。這些排尿障礙究竟是紅斑性狼瘡的臨床表徵之一,或是由其他原因所引起,仍需進一步的釐清。

英文摘要

OBJECTIVE: Systemic lupus erythematosus is a multisystem disease with a wide spectrum of clinical and laboratory features. Involvement of the urinary bladder is rarely mentioned in the literature. We conducted this study to examine lower urinary tract function in fe-male patients with SLE. METHODS: We conducted a prospective study on 145 consecutive female SLE patients receiving regular treatments in the Rheumatology Department from October 1999 through June 2000. Each patient was interviewed with a questionnaire comprised of the International Prostate Symptom Score and their clinical histories of SLE. Symptom scores were further correlated with disease severity, which was determined by the SLE disease activity index (SLEDAI) based on clinical and laboratory features. In addition, symptom scores obtained from 177 age-matched healthy females were used as a control. RESULT: Total symptom score(6.24±0.56 vs. 4.26±0.36), irritative symptom score(3.71±0.32 vs. 2.88±0.22), and obstructive symptom score(2.53±0.33 vs. 1.38±0.19) were all significantly higher in the SLE group when compared to the control group. The symptom score showed a significant correlation with disease activity(r=0.30, p<0.001), but not with disease duration (p>0.05). Overall, 45(31.0%)patients reported an IPSS of>7. Those who linked their urinary symptoms to SLE (n=29) had significantly higher symptom scores than those who did not (n=16). Thirty-eight (26.2%)patients reported being "mostly dissatisfied" with their urination. CONCLUSIONS: Our study suggests that a substantial number of women with SLE present with various degrees of voiding dysfunction that is significantly associated with disease activity. Whether voiding dysfunction is a clinical manifestation of lupus cystitis or secondary to other factors remains to be elucidated.