上海地区消化不良症状临床特点分析  

Analysis of clinical characters of dyspeptic symptoms in Shanghai patients

作　　者：李晓波[1] 刘文忠[1] 戈之铮[1] 张达荣[1] 赵蕴嘉[1] 薛寒冰[1] 戴军[1] 萧树东[1] 

机构地区：[1]上海第二医科大学附属仁济医院消化内科上海市消化疾病研究所,200001

出　　处：《中华消化杂志》2005年第3期142-145,共4页Chinese Journal of Digestion

摘　　要：目的分析上海地区消化不良症状特点,以提高消化不良的处理水平。方法连续调查782例消化不良患者,包括功能性消化不良(FD)和器质性消化不良患者(OD)的症状特点,患者填写调查表(包括12项消化不良症状),并根据症状程度进行评分,分析症状与进餐等因素的关系。结果782例消化不良患者中,FD543例(69.4%),OD239例(30.6%),OD组男性比例高于FD组。两组患者平均症状积分差异无统计学意义(21.5比20.4,P>0.05),但OD组上腹痛和饥饿痛的积分高于FD组(2.65±1.11比2.16±0.92,2.26±1.26比1.79±0.92,P值均<0.05)。OD和FD组中分别有45.2%和47.7%的患者症状与进餐无关;FD组溃疡样型、动力障碍样型和非特异型中分别有59.6%、50.9%和35.2%的患者症状与进餐无关。2.5%(6/239)的OD患者出现进行性吞咽困难,2.8%(15/543)的FD患者出现间歇性吞咽困难。8.8%(21/239)的OD患者出现体重显著减轻,同时伴有其他报警症状;而5.9%(32/543)的FD患者发生此症状,但均不伴有其他报警症状。13.8%的FD患者在随访1年中出现FD亚型间的转换。此外,OD患者幽门螺杆菌(Hp)阳性率(53.1%)显著高于FD(42.2%,P<0.01),FD亚型组间Hp感染率差异无统计学意义(P>0.05),OD和FD患者中Hp阳性者口臭症状发生率显著高于Hp阴性者(44.9%比17.0%,47.3%比25.4%,P值均<0.Objective To improve the management of dyspepsia by analyzing the clinical characters of dyspeptic symptoms in Shanghai patients. Methods Seven hundreds and eighty-two dyspeptic patients completed a questionnaire of dyspepsia, including 12 previously validated common upper abdominal ~symptoms with scoring of severity. The clinical characters of dyspepsia such as alarm symptoms, the ~relationship between symptoms and meals were then analyzed. Results Among 782 dyspeptic patients, 543 cases (69.4%) were functional dyspepsia (FD), and 239 (30.6%) organic dyspepsia (OD). The proportion of males was significantly higher in OD group than that in FD group. There was no difference in average dyspepsia scores between the two dyspeptic groups (21.5 vs. 20.4, P>0.05), but epigastric pain and epigastric pain before meals were more often presented in OD patients (2.65±1.11 vs. 2.16~±0.92 , 2.26±1.26 vs. 1.79±0.92,P<0.05). In 45.2% of OD patients and 47.7% of FD patients, the severity of symptoms was not related with meal, respectively. In subgroups of ulcer-like, ~dysmotility like and non-specific dyspepsia, the proportion of patients with symptoms not related to meal was ~59.6 %, 50.9% and 35.2%, respectively. About 2.5% (6/239) of OD patients presented with ~progressing dysphagia, compared with 2.8% (15/543) of FD patients presented with intermittent ~dysphagia . About 8.8% (21/239) of OD patients reported severe weight loss accompanied with other ~alarm symptoms, compared with 5.9% (32/543) of FD patients not with other alarm symptoms. Shifting of symptom subtypes during the follow-up period was found in 13.8% of FD patients. The infection rate of Helicobacter pylori was higher in OD group than that in FD group (53.1% vs. 42.2%, P<~0.01 ), but no difference was found among the three subgroups of FD patients (P<0.05). Halitosis was more often in dyspeptic patients with Helicobacter pylori infection (44.9% vs. 17.0% in OD, ~47.3% vs. ~25.4 % in FD, P<0.01).Conclusions When dyspepsia patients present with epigastric pain

关 键 词：上海 消化不良 临床特点 治疗 

分 类 号：R57[医药卫生—消化系统]