《中国康复理论与实践》

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膀胱疼痛综合征①

张杰1 综述,王强2,3 审校   

  1. 1. 首都医科大学附属北京地坛医院麻醉科,北京市100015;2. 中国康复研究中心北京博爱医院麻醉科,北京市100068;3. 首都医科大学康复医学院,北京市100068。
  • 出版日期:2016-05-25 发布日期:2016-07-04

Bladder Pain Syndrome (review)

ZHANG Jie1, WANG Qiang2,3   

  1. 1. Department of Anesthesiology and Operation Room, Capital Medical University, Beijing Ditan Hospital, Beijing 100015, China; 2. Department of Anesthesiology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China; 3. Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
  • Published:2016-05-25 Online:2016-07-04

摘要: 膀胱疼痛综合征是一种原因不明、发生在膀胱或其周围的慢性疼痛,伴有一系列泌尿系症状。女性人群及欧美国家发病率较高。它可以导致患者的生活质量降低,目前已形成一个新的残疾人群。可能的发病机制主要有病原体诱发炎性反应、慢性缺血或缺血再灌注损伤导致膀胱组织发生退行性病变、下尿道上皮功能障碍、膀胱组织中上皮细胞凋亡增加、遗传重编程、细胞内信号传导通路异常、疼痛调节机制异常、细胞自噬作用受到抑制等。尚缺乏统一的诊断标准,膀胱镜检、尿动力学参数、尿液及血液中的生物标记物有助于诊断。治疗方法有食物控制、心理干预、口服药物、膀胱灌注治疗、神经阻滞及神经刺激、手术治疗等,但效果均不满意。

关键词: 膀胱疼痛综合征, 残疾, 流行病学, 病因, 诊断, 治疗, 综述

Abstract: Bladder pain syndrome (BPS) is a chronic disease characterized by urinary symptoms and pain in or around the bladder with uncertain reasons. The incidence of BPS is higher in the female and people in American and Europen countries. The BPS patients' quality of life has been damaged and a new disabled group has been formed. The pathogeneses of BPS include pathogens inducing inflammation, chronic ischemia and ischemia- reperfusion injury producing degeneration in bladder, lower urinary epithelium dysfunction, apoptosis in bladder tissue, epigenetic reprogramming, abnormal intracellular signaling pathway, pain regulating dysfunctioning, and autophagy inhibited. There is no identified diagnosis for BPS. Cystoscopy, urodynamia, and biomarks in blood or urine are helpful in diagnosis. Diet, psychological intervention, oral medicine, intravesical therapy, nerve blocking and nerve stimulation, and surgeries have been used for it, but the efficacy remains unsatisfied.

Key words: bladder pain syndrome, disability, epidemiology, etiology, diagnosis, therapy, review