视觉模拟版IPSS评分表的应用评价

目的 评估视觉模拟版IPSS评分表(VAS-IPSS)对BPH患者的应用效果及影响因素分析.方法 选择未经治疗的BPH患者390例,随机分为2组,分别应用标准版IPSS和VAS-IPSS进行评分,2组分别再随机分为2个亚组,其中标准版IPSS组分为标准无讲解组(A组)和标准讲解组(B组),VAS-IPSS组分为图示无讲解组(C组)和图示讲解组(D组).讲解组在每次填写表格时接受医务人员对表格中描述性语言进行讲解,无讲解组由患者自行填写.间隔2周后,重复填写IPSS表,讲解组仍由医务人员进行讲解并协助填写.计算各组数据的组内相关系数( ICC),并用线性回归法探讨患者生活质量得分的最佳预测因子.结果 A、B、C、D组的ICC系数分别为0.87(95％ CI0.72 ～0.94 ),0.88(95％CI0.74 ～0.95),0.82(95％CI0.59 ～0.92),0.97(95％CI 0.93 ～0.99).A组的最佳预测因子为尿频(F=14.70,P=0.010),其次为夜尿(F=12.10,P=0.000)、尿急(F=11.80,p=0.000);B组最佳预测因子为夜尿(F =6.02,P=0.020),其次为尿不尽(F =5.79,P=0.008);C组最佳预测因子为夜尿(F =30.98,P=0.000),其次为尿不尽感(F=22.42,P=0.000);D组最佳预测因子为夜尿(F =20.20,P=0.000),其次为尿不尽感(F=18.00,P=0.000),尿线细(F=15.30,P=0.000).结论 VAS-IPSS的重测信度较标准版IPSS更为良好稳定,医务人员对评分条目的解释能够进一步提高VAS-IPSS的稳定性.

Evaluation of visual analog scale IPSS

Objective To evaluate the efficacy of visual analog scale international prostate symptom score (VAS-IPSS) in patients with benign prostate hyperplasia (BPH).Methods Three hundred and ninety patients with BPH were recruited to participate in this study and were randomly assigned to one of two groups:the standard IPSS group and the VAS-IPSS group.In each group,sub-groups were further divided to non-interpretation arm (A) and interpretation arm ( B),based on the availability of medical professionals to interpret patientsˊ VAS-IPSS score.In the same way,the similar sub-groups were established in VAS-IPSS group with non-interpretation arm (C) and interpretation arm (D).All the patients were required to fill out the same questionnaires at first consultation and second consultation with an interval of two weeks.Eventually,all the data were collected and analyzed.Results The ICC index was as follows for arms A through D:0.87 (95％CI0.72-0.94); 0.88 (95％CI0.74-0.95); 0.82 (95％CI0.59-0.92); 0.97(95％ CI 0.93-0.99).The optimal prediction factor for arm A was frequency (F =14.70,P =0.010)and the sub-optimal was nocturia ( F =12.10,P =0.000) and urgency ( F =11.80,P =0.000).The optimal prediction factor for arm B was nocturia ( F =6.02,P =0.000 ) and the sub-optimal was urinary incontinence ( F =5.79,P =0.008 ).The optimal prediction factor for arm C was nocturia ( F =30.98,P =0.000) and the sub-optimal was urinary incontinence ( F =22.42,P =0.000).The optimal prediction factor for arm D was nocturia ( F =20.20,P =0.000) and the sub-optimal was urinary incontinence ( F =18.00,P =0.000) and weak urine steam (F =15.30,P =0.000).Conclusions VAS-IPSS is more stable than the standard IPSS.The questionnaire explanation to patients is helpful for improving the VASIPSS stability.