罗马Ⅱ标准在肠易激综合征诊断中的价值  

The Value of Rome Ⅱ Criteria in the Diagnosis of Irritable Bowel Syndrome

作　　者：王如涛[1] 周惠清[1] 宋光辉[1] 刘清华[1] 许小幸[1] 李定国[1] 陆汉明[1] 

机构地区：[1]上海第二医科大学附属新华医院消化内科,200092

出　　处：《胃肠病学》2004年第4期227-229,共3页Chinese Journal of Gastroenterology

基　　金：上海市卫生局科学技术发展基金(No.01468)资助

摘　　要：背景:肠易激综合征(IBS)是一种慢性肠功能紊乱性疾病,其诊断标准对IBS患者的确诊至关重要。目的:评价罗马Ⅱ标准诊断IBS的真实性,及其对IBS与其他功能性或器质性消化系统疾病或与健康人鉴别的价值。方法:采用临床流行病学方法对499例来自消化内科门诊和体检中心的对象进行调查。由资深专家根据体格检查和辅助检查结果作出最终诊断,并以此为金标准,计算罗马Ⅱ标准用于IBS与其他功能性或器质性消化系统疾病或与健康人鉴别时的敏感性、特异性等指标。结果:罗马Ⅱ标准用于IBS与非溃疡性消化不良或与溃疡性结肠炎的鉴别时,敏感性及其95%CI相同,特异性及其95%CI、阳性预测值、阴性预测值、阳性似然比和阴性似然比相似,敏感性均为80%,特异性分别为51%和53%。结论:在临床实践中,如严格执行罗马Ⅱ标准,有可能使一部分症状发生频率较低的IBS患者被漏诊。Irritable bowel syndrome (IBS) is a chronic functional intestinal disorder. The diagnostic criterion is important for the final diagnosis of IBS patients. Aims: To evaluate the validity of Rome Ⅱ criteria in the diagnosis of IBS, and its value in the differential diagnosis between IBS and other functional or organic gastrointestinal diseases or healthy subjects. Methods: Four hundred and ninety-nine subjects from the gastroenterology clinic and medical examination center were studied epidemiologically. According to the results of physical and auxiliary examinations, the final diagnosis was made by the specialist and used it as a gold standard to calculate the sensitivity and specificity of Rome Ⅱ criteria in the differential diagnosis between IBS and other functional or organic gastrointestinal diseases or healthy subjects. Results: When Rome Ⅱ criteria was used in the differentiation of IBS and non-ulcer dyspepsia or ulcerative colitis, there were the same sensitivities and 95% CI, the similar specificities and 95% CI, and the similar positive and negative predictive values and positive and negative likelihood ratios. The sensitivities were both 80%, whilst the specificities were 51% and 53%, respectively. Conclusions: If Rome Ⅱ criteria is strictly employed in clinics, it is possible that a portion of IBS patients with lower frequency of symptomatic episode might be missed.

关 键 词：IBS 诊断 罗马Ⅱ标准 肠易激综合征 器质性 健康人 消化系统疾病 CI 预测值 价值 

分 类 号：R574[医药卫生—消化系统]