青少年儿童肠易激综合征的流行病学调查

An epidemiologic study of irritable bowel syndrome in adolescents

目的分析青少年儿童肠易激综合征(IBS)的患病率、分布特征(包括区域、学龄段、性别分布等)及其致病的相关危险因素。方法采用多级整群随机抽样方法,对黑龙江省与上海市共9所学校中5403名中小学生进行流行病学问卷调查,估算符合罗马Ⅱ诊断标准IBS的期间患病率,对其致病的相关危险因素进行单因素与多因素分析。结果推测被调查的两地中小学生符合罗马Ⅱ诊断标准的IBS患病率为13.25%,男女患病率差异无统计学意义(P>0.05)。区域性分层研究表明,患病率在黑龙江省(14.02%)和上海市(11.72%)之间差异有统计学意义(P<0.05)。学龄段分层研究表明,高中生患病率(17.80%)明显高于其他学龄段(P<0.01)。多因素回归分析表明,饮酒、吸烟、辛辣食物、痢疾史、腹部手术史、服用大量抗生素史、受凉、疲劳、心情焦虑、心情压抑及内向性格11个因素为最具可能性的危险因素,其OR值分别为1.25、1.44、1.13、1.37、1.63、1.93、2.83、1.10、1.07、1.13及1.05。结论IBS是青少年儿童人群的常见病和多发病。青少年儿童IBS患病率存在区域性与学龄段差异。心理因素、食物、不良外界环境因素及家庭环境因素等可能是诱发青少年儿童IBS致病的相关危险因素。

Objective To explore the prevalence of irritable bowel syndrome (IBS), its distribution characteristics and contributing factors among adolescent population in China. Methods A stratified, randomized study by cluster sampling was employed, which recruited 5403 subjects from 9 high and elemental schools in Heilongjiang province and Shanghai. All subjects recruited were requested to fill in a questionnaire. The prevalence of IBS diagnosed according to Rome Ⅱ criteria was evaluated. Contributing factors were explored by comparing frequencies between IBS group and non-IBS group using χ2 and Logistic analysis of multi-factors. Results The prevalence of IBS in adolescent population was 13.25%. The ratio of males to females was 1∶1.8 (P>0.05). There was a higher prevalence of IBS in Heilongjiang province (14.02%) than that in Shanghai (11.72%, P<0.05). The prevalence in 10-12 grade students (17.80%) was significantly higher than that of 1-9 grade students (P< 0.01). By multivariate Logistic regression analysis, the present study indicated that alcoholism (OR= 1.25), smoking (OR= 1.44), excessive intake of pepper (OR= 1.13), history of dysentery (OR= 1.37), abdominal operation (OR= 1.63), abuse of antibiotics (OR= 1.93), exposure to coldness (OR=2.83), fatigue syndrome (OR=1.10), anxiety (OR=1.07), depression (OR=1.13) and introvert personalities (OR= 1.05) might serve as important contributing factors (P<0.05).Conclusions IBS is a common disorder among the adolescent population. The prevalence of IBS is varied in different areas and school ages. The present study indicated that IBS of the adolescent population might be related with psychological factors, food habit, bad exterior environment and family condition, etc.