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肠易激综合征
Irritable Bowel Syndrome


Alexander C. Ford ... 其他 • 2017.06.29

关于肠易激综合征的认知进展

 

夏璐

上海嘉会国际医院,上海嘉会医疗中心

 

肠易激综合征(irritable bowel syndrome,IBS)是以腹部不适或腹痛伴随排便习惯改变为特征的一种常见的功能性胃肠道疾病。由于不同的社会、文化、地理和环境因素以及采用的IBS诊断标准和用于调查的问卷质量不同,因此各地调查的IBS患病率差异较大,在全球范围内,IBS患病率从1.1%至45.0%不等。在中国人群中符合罗马标准的IBS患病率为5.0%~6.0%1,2016年由中华医学会消化病学分会发布的中国肠易激综合征专家共识意见指出我国普通人群IBS总体患病率为6.5%,我国女性IBS患病率略高于男性,但在城乡间及不同教育程度者间无显著差异,肠道感染可能是中国人IBS的危险因素2

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肠易激综合征(irritable bowel syndrome,IBS)是一种慢性、有时引起失能的功能性肠病1,2。传统上,当未发现明显的结构或生化异常时,就会使用这一功能性诊断标签。但是,新证据提示,独特的病理生理学失调或可导致此病的症状;并且,IBS不大可能是一种疾病或单纯精神(躯体感觉)障碍2。罗马Ⅳ(Rome Ⅳ)标准1源自从多国功能性胃肠疾病专家组达成的共识,并构成了目前诊断IBS的标准。根据这些标准,IBS的诊断是基于与排便相关的反复腹痛,或反复腹痛伴排便频率或大便形态变化(表1)。气胀是常见的伴发症状。这些症状必须为慢性、在过去3个月内每周平均至少发作1次,且持续至少6个月。

 

表1. 诊断肠易激综合征的罗马标准*

* 资料来自Mearin等人的文章1。GI表示胃肠道。


IBS对生活质量和工作生产力带来了不利影响。据估计,只要能立即治愈IBS,患者宁肯少活10~15年3。美国的IBS患病率在7%~16%,且最常发生于女性和年轻人4。据保守估计,美国与IBS相关的直接成本超过10亿美元5。因此,准确诊断IBS、将有创检查减到最少以及推荐有效的治疗方案对于减少该疾病带来的社会和经济影响至关重要。





作者信息

Alexander C. Ford, M.D., Brian E. Lacy, M.D., and Nicholas J. Talley, M.D., Ph.D.
From the Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, and the Leeds Gastroenterology Institute, St. James’s University Hospital, Leeds, United Kingdom (A.C.F.); the Section of Gastroenterology and Hepatology, Dartmouth–Hitchcock Medical Center, Lebanon, NH (B.E.L.); the Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia (N.J.T.); the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN (N.J.T.); and Karolinska Institute, Stockholm (N.J.T.). Address reprint requests to Dr. Talley at the University of Newcastle, Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia, or

 

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