温州地区成年女性压力性尿失禁流行病学调查

目的:调查温州地区妇女有关尿失禁等尿路方面的问题,了解成年女性压力性尿失禁(SUI)的发病情况及发病的相关因素。方法:采用随机整群抽样方法对年龄在20岁以上的女性进行面对面问卷调查。结果:共获得1876份合格问卷,成年女性SUI患病率为22.6%,绝经后妇女SUI患病率为40.3%。多因素Logistic回归分析得出SUI患病的独立影响因素有年龄、体重指数、月经状态、便秘、慢性咳嗽、产程延长、胎儿体重、阴道分娩次数、分娩方式。温州地区SUI的就诊率仅7.3%。结论:温州地区成年女性SUI患病率较高,绝经后妇女SUI患病率接近50.0%。加强基层卫生保健工作,提高群众保健意识是降低SUI患病的有效措施。     

广州城区女性尿失禁的流行病学研究

目的:调查广州城区职工女性尿失禁的患病率、患病特点和相关影响因素。方法:对广州城区内8个单位的20岁以上成年女性共2 500人在妇科普查同时进行尿失禁症状现场调查,从20岁起每10岁为1个年龄段,分为6组。结果:共获得资料完整问卷2 480份,女性尿失禁的患病率为27.34%(678/2 480),压力性尿失禁、急迫性尿失禁和混合性尿失禁的患病率分别为16.01%(397/2 480)、2.98%(74/2 480)和8.35%(207/2 480)。随着年龄的增长,混合性尿失禁患病率增加。轻度尿失禁占84.96%(576/678),中重度占15.04%(102/678),>40岁占95.10%(97/102)。多因素Logistic回归表明年龄、阴道分娩、子宫及阴道壁膨出、肥胖、便秘和慢性咳嗽等是尿失禁发生的影响因素。结论:广州城区女职工尿失禁以轻度压力性尿失禁为主,随着年龄增大,中重度尿失禁发病增加,阴道分娩是尿失禁发生的重要影响因素。     

西非弗里敦市女性压力性尿失禁调查分析

目的探讨西非塞拉利昂共和国弗里敦市已婚生育女性压力性尿失禁(SUI)的患病情况及相关因素。方法对该市年满16岁以上就诊于中国医疗队的妇女进行问卷调查、根据年龄、孕产、分娩、产后劳动及慢性疾病史进行分析。结果尿失禁患病率为33.80%,并随着年龄的增加而患病率增加,并因分娩次数增多、阴道难产、产伤、产后劳动、合并心血管病、肺部疾病、糖尿病、子宫脱垂等致发病率增高。结论压力性尿失禁的发生是多因素综合的结果,加强孕产期保健与管理是降低SUI的有效措施。     

农村妇女压力性尿失禁调查结果及影响因素分析

目的:调查浙江省农村妇女压力性尿失禁(stress urinary incontinence,SUI)患病情况并探讨发病的影响因素。方法:对浙江省富阳地区农村妇女进行问卷调查,采用SPSS10.0软件进行数据录入及统计分析。结果:(1)5 127例调查对象中有压力性尿失禁症状者776例(15.1%);(2)未产妇、阴道分娩者和剖宫产者SUI的患病率分别为8.3%、15.8%、8.6%,阴道分娩与剖宫产分娩者患病率比较,差异有显著性(P<0.001);(3)随着分娩次数增加、年龄的增加,SUI发病率均呈上升趋势;(4)压力性尿失禁患者体重指数明显高于非尿失禁者(P<0.001)。结论:浙江省农村妇女压力性尿失禁患病率15.1%,生育次数、分娩方式、体重指数、年龄等是SUI发病的影响因素。     

北京市怀柔区女性压力性尿失禁流行病学调查

目的 调查北京市怀柔区女性压力性尿失禁患病现况,探讨疾病发生的相关因素.方法 采用整群抽样的方法,在妇科普查的过程中对3 420名妇女进行问卷调查,并行妇科检查.采用χ2检验进行各因素压力性尿失禁患病率的比较;采用非条件Logistic回归分析方法 计算优势比(OR)值及95%可信区间(CI),确定与压力性尿失禁有关的危险因素.结果 北京市怀柔区女性压力性尿失禁的患病率为28.89%.初产分娩方式为剖宫产者的患病率低于经阴道顺产和难产者,多产、会阴裂伤及产后劳动者的压力性尿失禁患病率在统计学上存在显著差异,OR(95%CI)分别为1.92(1.37～1.70)、1.38(1.12～1.69)和2.12(1.30～3.46),与压力性尿失禁患病率具有关联性.绝经、生殖系统肿瘤、子宫脱垂、阴道前后壁脱垂、尿路感染史、慢性支气管炎、心血管疾病、便秘等因素可使压力性尿失禁患病率显著增加,并且与压力性尿失禁患病具有相关性.另外,年龄、体重指数、职业、教育程度、居住环境、吸烟及入厕方式也与压力性尿失禁的患病具有相关性.结论 北京市怀柔区女性压力性尿失禁的发生率高,并且与年龄、肥胖、职业、生活方式、多次阴道分娩、分娩损伤、泌尿生殖系统疾病及某些慢性疾病等多因素相关.     

女性尿失禁的危险因素分析

目的 探讨女性尿失禁的危险因素.方法 对2006年1月～10月就诊于深圳市龙岗中心医院年龄为26～75岁的1 880例女性患者,以统一的调查表进行面对面问卷调查,对可能影响女性尿失禁的18个有关因素进行调查,并用多因素Logistic回归分析方法,筛查主要危险因素.结果 尿失禁的患病率为29.4%.最常见的尿失禁为压力性尿失禁,其发病率为20.6%;急迫性尿失禁次之,为7.0%;少部分患者为混和性尿失禁,为1.8%.年龄、体重指数、绝经、阴道分娩、阴道助产、尿路感染、便秘是女性压力性尿失禁的主要危险因素.结论 女性尿失禁的发病是多因素的结果,应积极地进行预防和治疗,提高妇女的生活质量.     

无锡地区女性压力性尿失禁流行病学调查研究

目的:调查无锡地区女性压力性尿失禁(SUI)发生的患病率及有关发病因素。方法:随机抽取无锡市新区鸿山镇17周岁以上的女性人群1 017例妇女问卷调查,进行一对一当面问卷。数据采用U、χ2检验。结果:压力性尿失禁患病率18.39%。SUI有随年龄及绝经后年限的增加而升高的趋势;工人、农民,高体重指数、高腹围、高血压,孕、产、流产次数、新生儿体重、阴道分娩、会阴裂伤、无会阴切开是压力性尿失禁的易患因素。结论:无锡地区女性压力性尿失禁患病率较高,影响因素很多,应引起广大医务人员及社会各界的重视,帮助患者早预防、早治疗,恢复其身心健康。     

分娩因素与尿失禁发生的相关性研究

目的调查产后妇女分娩时相关因素和产后尿失禁发生情况,探讨分娩相关因素与尿失禁(UI)发生的相关性。方法运用孕妇分娩因素调查问卷和国际尿失禁咨询委员会尿失禁标准问卷简表(ICI-Q-SF),对2015年4-9月在该院盆底中心就诊的245例产后妇女进行问卷调查。结果本次调查245例分娩后妇女,回收有效问卷237份,回收有效率为96.7%,发生UI者103例,发生率为43.5%,其中压力性尿失禁(SUI)发生率为76.7%,急迫性尿失禁(UUI)为4.9%,混合性尿失禁(MUI)为18.4%,不同年龄、分娩次数、分娩方式及有无会阴裂伤的分娩后妇女UI发生率组间比较差异有统计学意义(P0.05),多因素Logistic回归分析分娩后妇女的年龄、分娩次数、分娩方式及分娩时有无会阴裂伤与UI发生具有关联(P0.05)。结论分娩后女性UI发生率较高,年龄、分娩次数、分娩方式及分娩时有无会阴裂伤是UI发生的独立危险因素,做好保健预防,加强盆底肌功能训练可降低UI率。     

女性压力性尿失禁流行病学研究

目的调查城镇社区女性尿失禁发生的流行因素。方法随机对佛山市顺德区龙江镇5000名妇女妇科普查时同时问卷调查。结果问卷回收率93%。压力性尿失禁患病率29·85%,≥40岁占51·45%。结论压力性尿失禁的流行与年龄、多次的阴道分娩、难产、子宫脱垂、阴道前壁膨出、慢性咳嗽、便秘等多因素有关。     

女性压力性尿失禁发生相关因素研究

目的:研究女性压力性尿失禁的发病情况及相关影响因素,探讨可行的预防方法。方法:在进行妇科普查的过程中随机对770名妇女进行问卷调查。结果:女性压力性尿失禁发病率为40%(300/770),统计分析显示主要影响因素为:①一般情况:年龄增长、绝经、高体重指数,可使压力性尿失禁发生率增加,有显著性差异(P<0.05)。②分娩:阴道分娩、分娩次数>1次,哺乳时间≥1年,压力性尿失禁发生率明显增加(P<0.05)。③慢性疾病:反复尿路感染、慢性咳嗽、便秘、高血压和/或糖尿病患者中,压力性尿失禁发生率明显增加(P<0.05)。④妇科检查方面:会阴陈旧性裂伤、阴道前后壁膨出、子宫脱垂,压力性尿失禁发生明显增加,有显著性差异(P<0.05)。结论:北京地区女性压力性尿失禁发生率高,影响因素很多,其中大多数因素是可以预防的,做好孕产期保健,早期防治慢性咳嗽、便秘、尿感、糖尿病及高血压等疾病非常重要。     

Human arsenic exposure in relation to a copper smelter

Children living near a copper smelter in Tacoma, Washington, were shown to have increased levels of arsenic in hair and urine. The urinary arsenic level decreased with distance of residence from the smelter stack. House vacuum-cleaner dust showed a similar distance relationship. Urine arsenic levels in children varied synchronously over a 5-wk period, indicating that inhalation was the most likely exposure route. In children urinary arsenic level showed an inverse relationship to age with younger children showing consistently higher urine arsenic levels.A death-record analysis indicated an increased respiratory cancer incidence in men working at this smelter. Since published urinary arsenic levels for men working at this smelter were similar to those seen in people residing near the smelter, it was felt that the community surrounding the smelter might be exposed to an increased respiratory cancer risk. Accordingly, action was taken to reduce arsenic emissions from the smelter.     

Parity as a correlate of adult female urinary incontinence prevalence.

STUDY OBJECTIVE--The aim was to investigate the possible association between parity, as indicated by the number of childbirths, and prevalence of urinary incontinence in an adult female population sample. DESIGN AND SETTING--A sample of 3114 women aged 30-59 years was selected at random from the population of Aarhus, Denmark, and mailed a self administered questionnaire on urinary incontinence and, among other things, parity. PARTICIPANTS--A total of 2631 questionnaires was returned (85%) with a slight but significant decrease in respondency by age. MAIN RESULTS--The 1987 urinary incontinence period prevalence was 17%. Seventy eight percent were parous, and 24% had had three or more childbirths. In women aged 30-44 years, the prevalence of urinary incontinence was found to be associated with parity and, in women aged 45 years and more, with three or more childbirths. In parous women 30-44 years of age, the prevalence of urinary incontinence increased with age at least childbirth and, in women aged 45 years and over, it increased with increasing parity but decreased with increasing age at first childbirth. In parous women, no association was found with time since last childbirth. Among clinical types of urinary incontinence, stress incontinence consistently showed the strongest associations with indicators of parity. In women aged 30-44 years, nearly two thirds of the 1987 prevalence of stress incontinence could be attributed to parity. CONCLUSIONS--These findings support the hypothesis that pregnancy and childbirth are potent causes of female urinary incontinence, so that they exert considerable impact on the level of population urinary incontinence prevalence. In the individual woman, the effect seems to be cumulative and long lasting but fades with age.     

厦门社区成年女性尿失禁患病状况流行病学调查

目的:调查厦门社区成年女性尿失禁的患病率,探讨压力性尿失禁患病的影响因素。方法:采用分层随机抽样的方法,对厦门社区成年有性生活史的女性3 453例进行问卷调查,测量体重、身高及妇科检查。经单因素分析(χ2检验)及多因素Logistic回归分析筛选发生压力性尿失禁的危险因素。结果:本次共调查3 453例,年龄20～84岁,平均(45±16)岁。厦门市社区成年女性尿失禁患病率为38.78%(1 339/3 453)。盆腔器官脱垂的患病率为22.07%(762/3 453)。尿失禁的患病率总趋势随年龄增加而上升。在尿失禁(UI)患病状况分析中,发现SUI患病率23.52%(812/3 453),MUI患病率10.72%(370/3 453),UUI患病率3.91%(135/3 453),其他类型尿失禁患病率0.64%(22/3 453)。其构成比依次是60.64%、27.63%、10.08%、1.64%。经单因素分析χ2检验,筛选出SUI可能的危险因素有9项:年龄(χ2=103.604,P=0.000)、体重指数≥24 kg/m2(χ2=29.290,P=0.000)、体力劳动(χ2=11.662,P=0.001)、分娩方式(χ2=113.179,P=0.000)、文化程度(χ2=15.648,P=0.000)、慢性咳嗽(χ2=5.871,P=0.015)、高血压(χ2=13.540,P=0.000)、绝经(χ2=47.789,P=0.000)、盆腔器官脱垂(χ2=162.664,P=0.000)。影响SUI患病的多因素Logistic回归分析显示5项危险因素:分娩方式,与未产者相比,阴道分娩1次(OR值为3.016)、阴道分娩2次及以上(OR值为3.291),剖宫产(OR值为1.950);年龄,与20～39岁者相比,年龄在40～49岁者(OR值为1.448),年龄在50～59岁者(OR值为1.852),年龄在60岁及以上者(OR值为1.508);盆腔器官脱垂(OR值2.251);体力劳动(OR值1.275);慢性咳嗽(OR值2.221)。结论:尿失禁的患病率总趋势随年龄增加而上升,压力性尿失禁(SUI)患病的5个独立危险因素为:年龄、分娩方式、盆腔器官脱垂、体力劳动、慢性咳嗽。     

Urinary catecholamines in iron-deficient rats at rest and following surgical stress

The purpose of this study was to determine catecholamine concentrations both at rest and in response to a surgical stress in iron-deficient and control rats. Twenty-one-day-old rats were randomized to one of two groups which received a diet containing either 6 or 50 mg iron/kg. Three to five days later, when anemia was first detectable, urinary norepinephrine (NE) concentrations were already significantly elevated in the iron-deficient compared to control rats. In contrast, urinary dopamine (DA) became depressed after 10 days of the iron-deficient regimen. At 38 days of age, both groups were subjected to a surgical stress. NE and DA became elevated over baseline values in both diet groups during the 24-h period following surgery; NE remained significantly higher and DA significantly lower in the iron-deficient than in the control group. We conclude that changes in urine catecholamine concentration occur early in the development of iron deficiency and that they are characteristic of both baseline and stress conditions.     

北京市平谷区2009年重点人群尿碘监测结果

目的了解北京市平谷区学龄儿童、育龄妇女、孕妇的尿碘水平,为重点人群碘缺乏病防治工作提供科学依据。方法分别抽取8～10岁学龄儿童397名、育龄妇女205名和孕妇200名,采用尿碘砷铈催化分光光度测定方法进行尿碘检测。结果学龄儿童的尿碘中位数295.5μg/L,尿碘100μg/L的比例占93.20%,尿碘300μg/L的比例占49.12%,尿碘50μg/L的比例占3.78%;育龄妇女尿碘中位数是438.0μg/L,尿碘100μg/L的比例占98.05%,尿碘300μg/L的比例占82.44%,尿碘50μg/L的比例为零;孕妇尿碘中位数是392.3μg/L,尿碘100μg/L的比例占98.50%,尿碘300μg/L的比例占64.00%,尿碘50μg/L为零。结论平谷区重点人群碘摄入量处于较高水平,碘营养状况稍高于适宜水平。     

Exposure to inorganic arsenic in drinking water and total urinary arsenic concentration in a Chilean population

The relationship of inorganic arsenic exposure through drinking water and total urinary arsenic excretion in a nonoccupationally exposed population was evaluated in a cross-sectional study in three mayor cities of Chile (Antofagasta, Santiago, and Temuco). A total of 756 individuals in three population strata (elderly, students, and workers) provided first morning void urine specimens the day after exposure and food surveys were administered. Arsenic intake from drinking water was estimated from analysis of tap water samples, plus 24-h dietary recall and food frequency questionnaires. Multilevel analysis was used to evaluate the effects of the age group and city factors adjusted by predictor variables. Arsenic levels in drinking water and urine were significantly higher in Antofagasta compared with the other cities. City-and individual-level factors, 12% and 88%, respectively, accounted for the variability in urinary arsenic concentration. The main predictors of urinary arsenic concentration were total arsenic consumption through water and age. These findings indicate that arsenic concentration in drinking water continues to be the principal contributing factor to exposure to inorganic arsenic in the Chilean population.     

744名太原地区女性尿失禁患病情况分析

目的 调查太原地区女性尿失禁患病情况及其特点.方法 按照整群随机抽样方法,选取太原市北城区和涧河乡常住18岁以上成年女性进行问卷调查,并行妇科检查和POP-Q系统量化描述盆腔器官位置.结果 收集有效问卷744份,占抽样研究对象的93%.调查结果显示:女性尿失禁患病率49.33%,其中压力性尿失禁占64.03%,轻度尿失禁81.20%;尿失禁中有11.44%的女性其症状发生在冬春季节;随着孕次、产次的增多,尿失禁发生和失禁程度渐升高(P＜0.01);第一胎自娩有会阴撕裂者,产程中剖宫产和难产者尿失禁发生率明显高于其他组,而选择性剖宫产者尿失禁发生率则明显低于其他组;同时可见在家中分娩者尿失禁发生率明显高于在医院分娩者(P＜0.05),农村地区女性尿失禁发生率明显高于城市,有显著性差异(P＜0.01);产后1月内参加较重体力劳动,尿失禁的发生率增加;女性尿失禁中子宫脱垂、阴道前后壁脱垂的发生率显著高于正常组(P＜0.001),并且与女性压力性尿失禁的失禁程度呈明显正相关关系,相关系数r分别为0.160、0.249、0.217(P＜0.01).结论 尿失禁是女性常见疾病,农村地区高发,压力性和轻度尿失禁多见,且多伴发盆腔器官脱垂,治疗尿失禁和盆腔器官脱垂应兼顾.     

How should general practitioners investigate suspected urinary tract infection? Variations in laboratory-confirmed bacteriuria in South West England

We analysed by age and sex the inter-laboratory variation in submission rates and positivity rates of urine samples from primary care that were submitted to seven microbiology laboratories within the South West of England. There was an almost twofold difference between the lowest and highest submission and positivity rates across all sex and age groups. This could not be accounted for by differences in population, age mix or numbers of nursing home beds. Increased submission in children will increase diagnosis of urinary tract infection (UTI). In contrast, over-investigation in other age groups increases laboratory and primary care costs and, in the asymptomatic elderly, may lead to unnecessary antibiotic treatment. Continued education is needed in primary care to improve the management of urinary symptoms. Laboratory-based studies of UTI are likely to underestimate the true incidence of this infection substantially. Standardised protocols for urine specimen submission are essential for practices and laboratories participating in surveillance of UTI and antibiotic resistance. In our discussion we offer seven recommendations for improving UTI investigation in general practice.     

Prevalence, management and impact of urinary incontinence in the workplace

BACKGROUND: The few prior studies of urinary symptoms in the workplace have been small investigations of women in specific occupations (e.g. nursing) or industries (e.g. pottery manufacture). In this study, the aims were to describe the prevalence, management and impact of urinary incontinence for a large cross-section of employed women in the USA. METHODS: Five-page questionnaires were mailed to 5130 American households selected from the National Family Opinion survey panel during the spring of 2004. Usable questionnaires were returned by 3364 women in the target age range of 18-60 years. RESULTS: About 37% of the 2326 employed respondents reported urine loss during the last 30 days. The most common strategies for managing incontinence at work included frequent bathroom breaks and wearing pads. The use of urine control methods increased with the severity of urine loss. The effect of incontinence on workplace activities also increased with the severity of urine loss: 88% of employed women with the most severe symptoms reported at least some negative impact on concentration, performance of physical activities, self-confidence or the ability to complete tasks without interruption. CONCLUSION: Urinary incontinence is prevalent among employed women. Those who experience severe symptoms report that it has a negative effect on aspects of work. Programs on the prevalence and impact of urinary incontinence would help educate both employers and employees, and may lead to the development of better management techniques in the workplace.     

Urinary tract infection during pregnancy: its association with maternal morbidity and perinatal outcome.

OBJECTIVES. The effects of antepartum urinary tract infection on adverse maternal and perinatal outcomes were examined. Antepartum urinary tract infection has been previously implicated as a risk factor for numerous outcomes. METHODS. Crude and multivariable analyses were performed with a perinatal registry cohort of 25,746 mother/infant pairs. RESULTS. Elevated risks were observed for exposure to urinary tract infection and low birthweight, prematurity, preterm low birthweight, premature labor, hypertension/preeclampsia, maternal anemia, and amnionitis. Urinary tract infection was associated with perinatal death only among subjects 20 to 29 years of age. CONCLUSIONS. These findings underscore the importance of antepartum urine screening to identify patients at risk for adverse outcomes.