肠易激综合征诊断标准评价  

The evaluation of diagnostic criteria for irritable bowel syndrome

作　　者：许小幸[1] 李定国[2] 周惠清[2] 王彝康[2] 刘清华[2] 

机构地区：[1]上海第二医科大学临床流行病学研究中心,200092 [2]上海第二医科大学附属新华医院消化内科

出　　处：《中华消化杂志》2004年第12期720-723,共4页Chinese Journal of Digestion

基　　金：上海市卫生局科技发展基金项目 (0 14 68)

摘　　要：目的　评价Manning标准、罗马Ⅰ标准和罗马Ⅱ标准诊断IBS的真实性 ,并对适合我国人群的IBS诊断标准进行探讨。方法　采用自行设计的调查表对 72 4名来自上海第二医科大学附属新华医院消化内科的门诊患者和健康体检中心的体检人员进行问卷调查、体格检查和选择性辅助检查。其中 4 0 2例为IBS患者 ,134例为非溃疡性消化不良患者 ,90例为溃疡性结肠炎患者 ,98名为健康者。计算Manning标准、罗马Ⅰ标准、罗马Ⅱ标准诊断IBS的灵敏度和特异度及其 95 %CI、阳性预测值和阴性预测值、阳性似然比和阴性似然比。结果　Manning标准、罗马Ⅰ标准和罗马Ⅱ标准的灵敏度和特异度分别为 96 .0 2 % (95 %CI:95 .0 6 %～ 10 0 .0 % )、77.36 % (95 %CI:75 .31%～ 79.4 1% )、6 8.4 1% (95 %CI:6 6 .14 %～ 70 .6 8% )和 4 7.5 1% (95 %CI:4 4 .78%～ 5 0 .2 3% )、73.2 9% (95 %CI:70 .87%～ 75 .70 % )、83.2 3% (95 %CI:81.19%～ 85 .2 7% ) ;阳性预测值和阴性预测值分别为 6 9.5 5 %、78.33%、83.5 9%和90 .5 3%、72 .17%、6 7.85 % ,阳性似然比和阴性似然比分别为 1.83、2 .90、4 .0 7和 0 .0 8、0 .31、0 .38。结论　通过仔细采集病史的方法可作出IBS的正确诊断 ,罗马Ⅱ标准诊断IBS有较高的真实性。Objective To assess the diagnostic value of Manning's criteria, Rome Ⅰ criteria and Rome Ⅱ criteria in Chinese patients of irritable bowel syndrome. Methods 724 subjects were enrolled from the outpatient department of gastroenterology and the physical examination center of Xinhua hospital. Self designed questionnaire, routine physical examination and selective accessory diagnostic procedures were undergone in all subjects including 402 cases of irritable bowel syndrome,134 cases of non ulcer dyspepsia,90 cases of ulcerative colitis and 98 healthy controls. According to Manning criteria, Rome Ⅰcriteria and Rome Ⅱcriteria, the sensitivity, specificity, positive likelihood and negative predictive value(PV), positive likelihood and negative likelihood were calculated separately. Results The sensitivity and specificity of Manning's criteria, Rome Ⅰ criteria and Rome Ⅱcriteria were 96.02% (95%CI:95.06%-100.0%), 77.36% (75.31%-79.41%), 68.41% (66.14%-70.68%) and 47.51% (44.78%-50.23%), 73.29%(70.87%- 75.70 %) 83.23% (81.19%-85.27%),respectively. The positive PV and negative PV were 69.55%, 78.33% , 83.59% and 90.53%, 72.17%, 67.85%, respectively.The positive likelihood and negative likelihood were 1.83 , 2.90 , 4.07 and 0.08, 0.31, 0.38, respectively. Conclusion Irritable bowel syndrome could be positively diagnosed by taking an appropriate history and questionnaires,Rome Ⅱ criteria had higher validity in diagnosis of irritable bowel syndrome.

关 键 词：肠易激综合征 诊断标准 评价 问卷调查 非溃疡性消化不良 溃疡性结肠炎 

分 类 号：R574[医药卫生—消化系统]