Irritable bowel syndrome-like symptoms in treated microscopic colitis patients compared with controls:a cross-sectional study  

经过治疗的显微镜下结肠炎患者肠易激综合征样症状:一项横断面研究

作　　者：Jenny Pagoldh David Lundgren Ole B.Suhr Pontus Karling 

机构地区：[1]Department of Public Health and Clinical Medicine,UmeåUniversity,Umeå,Sweden

出　　处：《Gastroenterology Report》2020年第5期374-380,I0002,共8页胃肠病学报道（英文）

摘　　要：Background:The prevalence of irritable bowel syndrome(IBS)-like symptoms is high in untreated patients with microscopic colitis(MC),but there is uncertainty of the prevalence of IBS-like symptoms in treated patients.We assessed the degree of IBS-like symptoms in patients with MC in comparison to control subjects,and investigated the association between IBS-like symptoms and faecal calprotectin(FC)in MC patients.Methods:Patients with an established MC diagnosis(n=57)were compared to sex-and age-matched controls(n=138)for scores in the GSRS-IBS(Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome)and HADS(Hospital Anxiety Depression Scale).In MC patients,an FC level was simultaneously analysed.Results:The median interval from MC diagnoses to the time the subjects participated in the study was 5.5 years(25th-75th percentiles;4.5-9.5 years).The total GSRS-IBS score,subscores for abdominal pain,bloating,and diarrhoea were significantly higher in MC patients compared to controls(all P<0.001).There was a significant correlation between FC levels and reported bowel frequency(P=0.023),but there was no correlation between FC levels and GSRS-IBS scores.Patients with MC had significantly higher scores on anxiety(HADS-A)(P<0.001)and used more selective serotonin-reuptake-inhibitor drugs(P=0.016)than the control subjects.However,only the control subjects(not the patients with MC)showed significant correlations between GSRS-IBS scores and HADS scores.Conclusions:Patients with MC reported more IBS-like symptoms and anxiety than control subjects but neither FC levels nor symptoms of affectivity were significantly correlated with IBS-like symptoms.背景:未经治疗的显微镜下结肠炎(MC)患者常出现肠易激综合征(IBS)样症状,但治疗后MC患者IBS样症状的情况尚不明确。本研究旨在评估MC患者IBS样症状的出现频率,并分析IBS样症状与粪便钙卫蛋白的关系。方法:57例明确MC诊断的患者和按性别和年龄进行匹配的138名健康对照纳入研究,比较两组肠易激综合征胃肠症状分级量表(GSRSIBS)和医院焦虑抑郁量表(HADS)的评分结果。同时,检测MC患者FC水平。结果:MC患者从诊断至入组研究的中位间隔时间是5.5年(四分位数:4.5-9.5年)。MC患者GSRS-IBS总分、腹痛评分、腹胀评分及腹泻评分均显著高于对照组(均P<0.001)。FC水平与MC患者自诉的排便次数显著相关(P=0.023),但与GSRS-IBS评分无关。与对照组相比,MC患者HADS焦虑评分更高(P<0.001),服用选择性5-羟色胺再摄取抑制剂(抗抑郁药物)的比例更高(P=0.016)。然而,GSRS-IBS评分与HADS评分的相关性仅在对照人群中得到了证实,在MC患者中并未发现此种相关性。结论:与一般人群相比,MC患者更易出现IBS样症状及精神焦虑,但其FC水平或焦虑症状均与IBS样症状无关。

关 键 词：microscopic colitis irritable bowel syndrome CALPROTECTIN ANXIETY DEPRESSION 

分 类 号：R574.62[医药卫生—消化系统]