Giardia lamblia infection in patients with irritable bowel syndrome and dyspepsia:A prospective study  

作　　者：Barbara Grazioli Giovanni Matera Costanza Laratta Giuseppina Schipani Giovanni Guarnieri Ester Spiniello Maria Imeneo Andrea Amorosi Alfredo Focà Francesco Luzza 

机构地区：[1]Dipartimento di Medicina Sperimentale e Clinica, Cattedra di Gastroenterologia Università di Catanzaro 'Magma Graecia', Catanzaro, Italy [2]Dipartimento di Scienze Mediche, Istituto di Microbiologia Università di Catanzaro 'Magna Graecia', Catanzaro, Italy [3]Dipartimento di Medicina Sperimentale e Clinica, Cattedra di Anatomia Patologica Universith di Catanzaro 'Magna Graecia', Catanzaro, Italy

出　　处：《World Journal of Gastroenterology》2006年第12期1941-1944,共4页世界胃肠病学杂志（英文版）

摘　　要：AIM： To evaluate the prevalence of Giardia lamblia （G. lamblia） infection in patients with irritable bowel syndrome （IBS） and dyspepsia and to establish which is the most accurate test to diagnose the infection in this setting. METHODS： One hundred and thirty-seven patients who consecutively attended the Outpatient Gastroenterology Clinic for the first time between January 2002 and Decernber 2003 due to symptoms of IBS and/or dyspepsia were recruited. All patients underwent clinical evaluation, first-step haematology and chemistry tests, serologic assays for celiac disease, lactose-H2 breath test, abdominal ultrasonography, and esophagogastroduodenoscopy. Helicobacterpylon status was evaluated. In patients with symptoms of IBS older than 45 years, colonoscopy was also performed. In all patients, duodenal biopsies and stool samples were examined for trophozoites and cysts of G. lamblia by several methods. RESULTS： G. lamblia was identified in 9 patients. The following diagnoses were also made： IBS （100/137, 73%）, functional dyspepsia （62/137, 45%）, organic dyspepsia （33/137, 24%）, and lactose intolerance （75/137, 55%）. A significant association was found between giardiasis and H pylori infection （x^2= 6.632, OR= 12.4, CI= 1.5-68.1）. There were no symptoms that reliably allowed the recognition of giardiasis. Direct search of the parasite in duodenal biopsy and stool sample examinations gave concordant results in all cases while histological examination of duodenal biopsies displayed a low sensitivity （e.g., 22.2%）. CONCLUSION： In this consecutive series, diagnosis of G.lamblia infection accounted for 6.5% of patients with IBS and dyspepsia. Duodenal biopsies for diagnosis of giardiasis may be unnecessary if stool sample examination is performed.瞄准：评估兰伯氏贾第虫的流行(G。兰氏鞭毛虫属) 在有急躁的肠症候群(IBS ) 和消化不良并且到的病人的感染证实哪个是最精确的测试在这个背景诊断感染。方法：连续地由于 IBS 或消化不良的症状在 2002 年 1 月和 2003 年 12 月之间第一次出席了门诊病人肠胃病学诊所的 137 个病人被招募。所有病人经历了临床的评估，第一步的 haematology 和化学测试，为乳糜泻的血清学试金， lactose-H (2 ) 呼吸测试，腹的 ultrasonography，和 esophagogastroduodenoscopy。Helicobacter pylori 地位被评估。在有比 45 年旧的 IBS 的症状的病人，结肠镜检查也被执行。在所有病人，十二指肠的活体检视和凳子样品为 G 的 trophozoites 和包囊被检验。由几个方法的兰氏鞭毛虫属。结果：G。兰氏鞭毛虫属在 9 个病人被识别。下列诊断也被做：IBS (100/137， 73%) ，机能性消化不良(62/137， 45%) ，器官的消化不良(33/137， 24%) ，并且乳糖不耐(75/137， 55%) 。一个重要协会在贾第虫病和 H pylori 感染之间被发现(c2=6.632， OR=12.4， CI=1.5-68.1 ) 。没有症状，可靠地允许贾第虫病的识别。当十二指肠的活体检视的组织学的检查显示了低敏感时，在十二指肠的活体检视和凳子样品考试的寄生虫的直接搜索在所有情况中给了一致结果(例如， 22.2%) 。结论：在这个连续系列， G 的诊断。兰氏鞭毛虫属感染与 IBS 和消化不良说明了 6.5% 病人。如果凳子样品检查被执行，为贾第虫病的诊断的十二指肠的活体检视可能是不必要的。

关 键 词：DYSPEPSIA GIARDIASIS H pylori Irritablebowel syndrome 

分 类 号：R574[医药卫生—消化系统]