肠易激综合征患者症状特点及严重程度影响因素分析  

Symptomatic characteristics and factors related to severity of irritable bowel syndrome

作　　者：樊文娟[1] 常敏[1] 李晓青[1] 朱丽明[1] 费贵军[1] 方秀才[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院消化内科,北京100730

出　　处：《中华全科医师杂志》2017年第9期668-671,共4页Chinese Journal of General Practitioners

摘　　要：目的 了解我国肠易激综合征（IBS）患者的症状特点和影响其严重程度的因素.方法 纳入2009年6月至2016年2月我院就诊的符合罗马Ⅲ诊断标准的516例IBS患者,面对面完成IBS调查问卷,包括肠道症状、合并症状和睡眠精神状态,并根据症状计分划分IBS的严重程度.结果516例IBS患者中,轻、中和重度患者分别占26.2％ （135/516）、51.7％ （267/516）和22.1％（114/516）.IBS患者排便前腹痛/腹部不适部位以脐周最常见（34.6％,178/516）,有53.3％（275/516）的患者平时也存在腹痛/腹部不适.分别有51.2％ （264/516）和59.1％（305/516）的患者合并胃食管反流病（GERD）和功能性消化不良（FD）,46.9％（242/516）的患者合并抑郁.中重度症状组患者平时腹痛/腹部不适[57.0％ （217/381）比43.0％（58/135）,x2=7.841]、排便不尽感[74.5％（284/381）比61.5％（83/135）,x2=8.277]以及合并GERD[54.1％ （206/381）比43.0％（58/135）,x2=4.920]、FD[64.0％ （244/381）比45.2％ （61/135）,x2=14.664]、头痛[50.7％（193/381）比38.5％（52/135）,x2=5.889]和抑郁[52.2％（199/381）比31.9％ （43/135）,x2=16.623]的发生率明显高于轻度症状组（均P ＜0.05）.合并FD（OR=1.798,95％ CI：1.162 ～2.783）和抑郁（OR=1.696,95％ CI：1.043～2.759）是患者症状为中重度的危险因素.结论 IBS患者临床症状多变,合并症状发生率高,合并FD和抑郁的患者易出现中重度症状,正确识别IBS的症状特点和严重程度具有重要意义.Objective To analyze symptomatic characteristics and the factors related to severity of irritable bowel syndrome （IBS）.Methods Total 516 IBS patients met Rome Ⅲ criteria were enrolled in the study from June 2009 to February 2016.A questionnaire survey was conducted in face-to-face manner,including intestinal and extra-intestinal symptoms,sleeping and psychological status.Severity of IBS was determined by symptom scores.Results Among 516 patients,there were 135 cases with mild symptoms （26.2%）,267 with moderate symptoms （51.7%） and 114 with severe symptoms （22.1%）.Periumbilical pain/discomfort associated with defecation was a common symptom location （34.6%,178/516）,however,53.3% （275/516） patients also reported having abdominal pain/discomfort during non-defecation period.In IBS patients,51.2% （264/516） were coexisted with gastroesophageal reflux disease （GERD）,59.1% （305/516） with functional dyspepsia （FD）,and 46.9% （242/516） with depression.The prevalence of ordinary abdominal pain/discomfort [57.0% （217/381） vs.43.0% （58/135）,x2 =7.841],sensation of incomplete defecation[74.5% （284/381）vs.61.5% （83/135）,x2 =8.277] and coexisted GERD[54.1% （206/381） vs.43.0%（58/135）,x2 =4.920],FD[64.0%（244/381）vs.45.2% （61/135）,x2 =14.664],headache[50.7% （193/381）vs.38.5% （52/135）,x2 =5.889] and depression[52.2% （199/ 381）vs.31.9% （43/135）,x2 =16.623] in patients with moderate to severe symptoms were significantly higher than that in patients with mild symptoms （all P 〈 0.05）.The predictors to moderate-severe IBS symptoms were coexisted FD （OR =1.798,95% CI：1.162-2.783,P =0.010） and depression （OR =1.696,95% CI：1.043-2.759,P =0.014）.Conclusion The symptoms of IBS patients are various,and patients coexisted with FD and depression are more likely to have more severe symptoms.

关 键 词：肠易激综合征 疾病严重程度指数 合并症 

分 类 号：R574.4[医药卫生—消化系统]