摘要
目的比较功能性消化不良(FD)罗马Ⅱ与罗马Ⅲ诊断标准的异同点,提高对罗马Ⅲ标准的认识。方法2006年7月至8月上消化道内镜检查患者2552例,其中2195例同意接受问卷调查,其中有554例临床诊断为FD,按罗马Ⅱ和罗马Ⅲ标准进行诊断及分型,比较两种诊断标准的差异和两组患者临床资料的异同。结果①554例FD患者中符合罗马Ⅱ标准的有121例(21.84%),符合罗马Ⅲ标准的有158例(28.52%),两个标准对FD诊断率的差异有统计学意义(P=0.001);同时符合罗马Ⅱ和罗马Ⅲ标准的有71例。②按罗马Ⅱ和罗马Ⅲ标准诊断为FD的两组患者均以女性为主,但性别、年龄、发病病程比较差异均无统计学意义(P值分别=0.830、0.711和0.802)。③按罗马Ⅱ标准分型,溃疡样型82例(67.77%),运动障碍型34例(28.10%),非特异型5例(4.13%);按照罗马Ⅲ标准分型,仅符合上腹痛综合征(EPS)者为75.32%(119/158),仅符合餐后不适综合征(PDS)者为15.82%(25/158),同时符合PDS和EPS标准者为8.86%(14/158)。④按罗马Ⅱ和罗马Ⅲ标准诊断为FD的患者,上腹痛、腹胀、早饱、餐后饱胀、上腹饱胀、上腹烧灼、烧心、恶心、呕吐、反酸、嗳气、食欲下降的发生率差异均无统计学意义(P<0.05);符合罗马Ⅱ标准的FD患者上腹不适症状发生率高于符合罗马Ⅲ标准的患者(P= 0.012)。⑤两组分别有11.57%(14/121)和13.92%(22/158)患者伴有下消化道症状,组间比较差异无统计学意义(P=0.561)。结论在FD诊断率上罗马Ⅲ标准高于罗马Ⅱ标准,且罗马Ⅲ标准更利于操作和评估。在患者一般情况及临床症状等资料方面两项标准比较差异无统计学意义。由于样本量较少,结论有待进一步研究评价。
Objective To compare the Rome Ⅲ and Ⅱ diagnostic criteria of functional dyspepsia （FD）, so as to well understand the Rome Ⅲ criteria. Methods Two thousand and one hundred ninty-five of 2552 patients who undertook superior gastrointestinal endoscopy filled the inquiry questionnaire. Five hundred fifty-four cases were suspected with FD, which were diagnosed and classified according to the Rome Ⅲ and Ⅱ criteria. The differences of the diagnosis and the clinic data according to two criteria were compared. Results （1） Of the 554 suspected FD patients, 121（21.84%） and 158（28. 52%） patients were consistent with Rome Ⅱ or Rome Ⅲ criteria, respectively, whilst 71 were consistent with Rome Ⅱ and Rome Ⅲ simultaneously（P = 0. 001）. （2） Patients diagnosed with FD according to Rome Ⅱ or Ⅲ were mainly female, there were no differences between the two groups in the gender ratio, age, course of disease（ P = 0. 830, 0.7Ⅱ, 0,802, respectively）. （3） According to Rome Ⅱ criteria, ulcer-like was found in 82 patients（67.77%）, dyscinesia in 34（28. 10%） patients, non-idiotype in 5（4.13%） patients, while according to Rome Ⅲ criterla, 75.32 % （119/158） patients were consistent with epigastric pain syndrome （EPS）, 15. 82% （25/158） patients were consistent with postprandial distress syndrome, and 8. 86% （14/158） patients with PDS and EPS simultaneously. （4） There were no statistical difference between patients diagnosed according to Rome Ⅱ or Rome m in symptoms of upper abdominal pain, abdominal distention, early satiety, distension after meal, epigastric distension and cautery, heartburn, nausea, vomiting, sour regurgitation and hiccup. The epigastric discomfort patients diagnosed with Rome llcriteria were more than those with Rome Ili （P = 0. 012）. （5） The lower digestive tract symptoms were found in 11. 57% （14/121） patients diagnosed with Rome Ⅱ and 13. 92% （22/158） patients with Rome Ⅲ（P = 0. 561 ）. Conclusions Rome m criteria is not only superior in diagnosis of FD, but also easy to manipulate and evaluate. There is no statistical difference between two criteria in diagnosis of clinical presentation. The result needs further extensive study.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2007年第12期809-812,共4页
Chinese Journal of Digestion
关键词
胃肠疾病
消化不良
诊断
Gastrointestinal diseases
Dyspepsia
Diagnosis
