肠易激综合征多维度临床表现特征的多中心横断面研究  

A multicenter cross-sectional study on the multidimensional clinical manifestations of irritable bowel syndrome

作　　者：周丹[1] 龙艳芹 段志军[3] 杨杰 张智峰[3] 武君 蔡联英[5] 梁列新[5] 戴宁[6] 张军[7] 白涛[1] 侯晓华[1] Zhou Dan;Long Yanqin;Duan Zhijun;Yang Jie;Zhang Zhifeng;Wu Jun;Cai Lianying;Liang Liexin;Dai Ning;Zhang Jun;Bai Tao;Hou Xiaohua(Department of Gastroenterology,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Gastroenterology,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Gastroenterology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;Department of Gastroenterology,the Affiliated Hospital of Guizhou Medical University,Guizhou 550004,China;Department of Gastroenterology,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;Department of Gastroenterology,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,China;Department of Gastroenterology,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China)

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]浙江大学医学院附属第一医院消化内科,杭州310003 [3]大连医科大学第一附属医院消化内科,大连116011 [4]贵州医科大学附属医院消化内科,贵州550004 [5]广西壮族自治区人民医院消化内科,南宁530021 [6]浙江大学医学院附属邵逸夫医院消化内科,杭州310016 [7]西安交通大学第二附属医院消化内科,西安710004

出　　处：《中华消化杂志》2023年第10期683-689,共7页Chinese Journal of Digestion

摘　　要：目的评估按照罗马Ⅲ标准诊断的肠易激综合征(IBS)患者中,符合罗马Ⅲ但不符合罗马Ⅳ标准的IBS患者与符合罗马Ⅳ标准的IBS患者的多维度临床表现特征差异。方法选择2016年11月至2017年10月华中科技大学同济医学院附属协和医院(139例)、浙江大学医学院附属邵逸夫医院(95例)、大连医科大学第一附属医院(96例)、贵州医科大学附属医院(90例)、广西壮族自治区人民医院(20例)、西安交通大学第二附属医院(32例)共6家医院收治的472例IBS患者。将472例IBS患者分为符合罗马Ⅳ标准组(以下简称罗马Ⅳ组)和符合罗马Ⅲ但不符合罗马Ⅳ标准组(以下简称罗马Ⅲ组),通过面对面填写问卷的方式,比较两组患者基本特征(IBS病程、感染后IBS、吸烟史、饮酒史等)、腹部症状和排便相关症状差异,完成多维度临床表现评估,包括胃肠道症状评分量表(GSRS)、肠易激综合征严重程度评分系统(IBS-SSS)、肠易激综合征生活质量量表(IBS-QOL)和医院焦虑抑郁量表(HADS)评分。采用独立样本t检验、秩和检验和卡方检验进行统计学分析。结果罗马Ⅳ组患者344例(72.9%),罗马Ⅲ组患者128例(27.1%)。罗马Ⅳ组患者IBS病程长于罗马Ⅲ组患者[3.0年(7.0年)比2.0年(5.7年)],差异有统计学意义(Z=-2.73,P=0.006)。罗马Ⅳ组IBS患者稀便、腹痛的GSRS评分高于罗马Ⅲ组患者,但排气增多、腹胀的GSRS评分低于罗马Ⅲ组患者[3.0分(2.0分)比2.0分(4.0分)、3.0分(2.0分)比1.0分(2.0分)、1.5分(3.0分)比2.0分(3.0分)、1.0分(3.0分)比2.0分(3.0分)],差异均有统计学意义(Z=-2.48、-9.90、-2.11、-2.06,P=0.013、<0.001、=0.035、=0.040)。罗马Ⅳ组IBS患者疲劳和眩晕的比例高于罗马Ⅲ组患者[58.4%(201/344)比43.0%(55/128)、30.8%(106/344)比29.7%(38/128)],差异均有统计学意义(χ^(2)=8.37、12.36,P=0.004、<0.001)。罗马Ⅳ组IBS患者HADS的焦虑和抑郁子量表评分均高于罗马Ⅲ组患者[6.5分(6.8�Objective To assess the differences in multidimensional clinical manifestations between patients with irritable bowel syndrome(IBS)matching the RomeⅢcriteria but not matching RomeⅣand IBS patients matching the RomeⅣcriteria,among patients diagnosed with IBS according to RomeⅢcriteria.Methods From November 2016 to October 2017,a total of 472 IBS patients admitted to six hospitals were selected,which included Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology(139 cases),Sir Run Run Shaw Hospital,School of Medicine of Zhejiang University(95 cases),the First Affiliated Hospital of Dalian Medical University(96 cases),the Affiliated Hospital of Guizhou Medical University(90 cases),the People′s Hospital of Guangxi Zhuang Autonomous Region(20 cases),and the Second Affiliated Hospital of Xi′an Jiaotong University(32 cases).The 472 IBS patients were divided into the group that matching the RomeⅣcriteria(RomeⅣgroup),and the group that matching the RomeⅢcriteria but not matching the RomeⅣcriteria(RomeⅢgroup).The basic characteristics(IBS course,post-infectious IBS,history of smoking or drinking,etc.),abdominal symptoms,and defecation-related symptoms of two groups were compared and analyzed by face-to-face questionnaires.Multi-dimensional clinical manifestations assessment was completed by questionnaires,which included gastrointestinal symptom rating scale(GSRS),irritable bowel syndrome-severity scoring system(IBS-SSS),irritable bowel syndrome-quality of life(IBS-QOL),and hospital anxiety and depression scale(HADS).Independent sample t-test,rank sum test,and chi-square test were used for statistical analysis.Results There were 344 patients(72.9%)in RomeⅣgroup and 128 patients(27.1%)in RomeⅢgroup.The IBS course of patients in RomeⅣgroup was longer than that in RomeⅢgroup(3.0 years(7.0 years)vs.2.0 years(5.7 years)),and the difference was statistically significant(Z=-2.73,P=0.006).The GSRS scores of loose stools and abdominal pain of IBS patients i

关 键 词：肠易激综合征 罗马Ⅳ诊断标准 流行病学 诊断 生活质量 

分 类 号：R574.4[医药卫生—消化系统]