罗马Ⅲ标准研究肠易激综合征临床特点及亚型

Clinical features and subtypes of irritable bowel syndrome based on RomeⅢdiagnostic criteria

目的:应用功能性胃肠病罗马Ⅲ诊断标准研究肠易激综合征(IBS)的临床特点及亚型分布.方法:应用罗马Ⅲ诊断标准,对消化科门诊IBS患者进行诊断和亚型分类,大便性状按照Bristol分级,统计学分析应用SPSS软件进行统计学处理.结果:罗马Ⅲ标准诊断IBS患者487例,年龄18-78岁,病程6-720 mo;病程达12 mo以上者420例,占86.2%,6-12 mo者67例,占13.8%.常见的消化道外的伴随症状依次为乏力、腰背痛、失眠、头晕、胸闷、体质量下降(≥5 kg)、头痛、尿频、咽部异物感、肩痛、眼球痛、胸痛.诊断为腹泻型IBS(IBS-D)者316例(65%),便秘型IBS(IBS-C)者59例(12%),混合型IBS(IBS-M)者24例(5%),未定型IBS(IBS-U)者88例(18%).病程中发生亚型转化者16例,占3.29%.不同的IBS亚型性别分布不同(x^2= 30.86,P<0.05),IBS-C和IBS-U中女性较多,IBS-D中男性较多(P<0.05).不同的IBS亚型年龄分布无统计学差异(x^2=16.67,P>0.05).结论:罗马Ⅲ诊断标准可提高IBS的早期诊断率.按照IBS罗马Ⅲ诊断标准,IBS-D最多见,约占2/3;其次为IBS-U,IBS-C及IBS-M.IBS-U在临床上不少见,这一新的亚型值得进一步研究.

AIM： To investigate the clinical features and subtypes of irritable bowel syndrome （IBS） based on Rome Ⅲ diagnostic criteria. METHODS： A total of 487 consecutive out- patients presented to the gastroenterological clinic were diagnosed with IBS based on Rome Ⅲ diagnostic criteria. The forms of stool were assessed by Bristol stool form scale. Statistical analysis was performed using SPSS. RESULTS： All the patients fulfilled the Rome Ⅲ criteria for IBS. Their age was 18 to 78 years and the disease course was 6 to 720 months. The disease course was over 12 months in 420 patients （86.2%） and 6-12 months in 67 patients （13.8%）. The other symptoms outside the gastrointestinal （GI） tract were acratia, backache, insomnia, dizziness, chest distress, weight loss（≥ 5 kg）, headache, frequency of micturition, foreign body sensation in throat, shoulder pain, eyeball pain and chest pain. Three hundred and sixteen patients （65%） were diagnosed as IBS with diarrhea（IBS-D）, 59 （12%） as IBS with constipation（IBS-C）, 24 （5%） as mixed IBS （IBS-M） and 88 （18%） as unsubtyped IBS （IBS-U）. Of the 487 patients, subtype alteration occurred in 16 （3.29%） patients during the disease course. Among the four subtypes, sex difference was significant （P 〈 0.05）. IBS-C and IBS-U were more prevalent in females, while IBS-D was more common in males（P 〈 0.05）. However, the subtypes of IBS were similar among different ages（P 〉 0.05）. CONCLUSION： Rome Ⅲ diagnostic criteria can improve the early diagnostic rate of IBS. According to Rome Ⅲ diagnostic criteria, IBS-D is most common, accounting for about 2/3 of IBS cases followed by IBS-U, IBS-C and IBS-M. IBS-U deserves further investigation.