功能性便秘和便秘型肠易激综合征相关生活因素上的差异  

Differences in lifestyle factors between functional constipation and constipation-predominant irritable bowel syndrome

作　　者：罗昶[1] 吕尚泽 白涛[1] 向雪莲[1] 侯晓华[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院消化内科,武汉430022 [2]华中科技大学同济医学院附属荆州医院消化内科

出　　处：《中华消化杂志》2015年第7期460-464,共5页Chinese Journal of Digestion

基　　金：卫生部临床重点专科建设项目（2011～2013）

摘　　要：目的比较功能性便秘（FC）与便秘型IBS患者相关生活因素的差异。方法纳入2011年2月至2014年12月的255例慢性便秘患者，其中FC170例，便秘型IBS85例。另纳入同期1年内无消化道症状的170名健康者作为对照组。收集所有纳人者的人口学基本资料、生活习惯资料等。先行单因素分析，将差异有统计学意义的变量纳入多因素Logistic回归分析。再将FC和便秘型IBS的各因素纳入决策树模型，分析不同分类下影响因素的作用。结果单因素分析显示，FC组与便秘型IBS组各生活因素比较差异均无统计学意义（P均〉0．05）。多因素Logistic回归分析显示，与FC组比较，便秘型IBS组未发现独立保护或危险因素。经过决策树模型分析，最终纳入BMI、每日饮水量和便秘家族史3个变量，当BMI〈23．56kg／m2（除外18．74～〈19．83kg／m2）时，患FC的概率高（最高达79．75％）；当BMI为18．74-〈19．83kg／m2，每日饮水量少（〈1L）时，患FC的概率高（66．67％）；当BMI≥23．56kg／m2，有便秘家族史时，患便秘型IBS的概率最高（70．00％）。该模型的整体预测准确率为64．6％（42／65），AUC值为0．688。结论FC和便秘型IBS的发生与多种生活因素密切相关，BMI低和每日饮水量少是FC的影响因素，BMI较高和有便秘家族史是便秘型IBS的影响因素。Objective To compare the differences of lifestyle factors between patients with functional constipation （FC） and constipation-predominant irritable bowel syndrome （IBS-C）. Methods From February 2011 to December 2014, 255 patients with chronic constipation were enrolled. Among them, there were 170 FC patients and 85 IBS-C patients. At the same period, 170 healthy volunteers without symptoms of digestive diseases within one year were recruited as control. The data of demographic information and lifestyle factors were collected. First, single variant analysis was performed for statistical analysis and then the statistically significant variants were analyzed by multivariate logistic regression. Then the factors of FC and IBS-C patients were analyzed by decision tree model and the effects of factors under different categories were analyzed. Results The results of single variant analysis indicated that there was no difference in lifestyle factors between FC group and IBS-C group （all P〉0. 05）. The results of multivariate logistic regression analysis showed that no independent protective or risk factors were found in IBS-C group compared with FC group. According to decision tree model analysis, body mass index （BMI）, water intake per day and constipation family history were finally enrolled. The incidence of FC was higher in patients with BMI〈23. 56 kg/m2（except 18. 74 to %19. 83 kg/m2） （79. 75%）. The incidence of FC was higher in patients with BMI from 18.74 to %19.83 kg/m2 and water intake %1 L（66.67%）. The incidence of FC was highest in patients with BMI≥23. 56 kg/m2 and family history of constipation （70.00%）. The total prediction accuracy of this model was 64.6% （42/65） and area under curve （AUC） value was 0. 688. Conclusions FC and IBS-C are related with many lifestyle factors. Low BMI and less water intake per day are influence factors of FC, while higher BMI and family history of constipation are influence factors of IBS-C.

关 键 词：功能性便秘 便秘型肠易激综合征 生活因素 逻辑回归 决策树 

分 类 号：R574[医药卫生—消化系统]