论文部分内容阅读
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 similarities and differences of diagnostic criteria between Roman Ⅱ and Roman Ⅲ in functional dyspepsia (FD), and to improve the understanding of Rome Ⅲ standard. Methods From July to August 2006, 2552 patients were enrolled in upper gastrointestinal endoscopy. Among them, 2195 patients agreed to be surveyed. Among them, 554 were diagnosed as FD according to the diagnostic criteria of Rome Ⅱ and Rome Ⅲ, Differences in diagnostic criteria and clinical data of the two groups of similarities and differences. Results Among the 554 FD patients, 121 (21.84%) met the criteria of Rome Ⅱ and 158 (28.52%) met the criteria of Rome Ⅲ. There was significant difference between the two standards in the diagnostic rate of FD (P = 0.001) ; While in line with the Rome Ⅱ and Rome Ⅲ standards in 71 cases. ② The two groups of patients who were diagnosed as FD by Roman II and Rome III were all female. There was no significant difference in gender, age and course of disease (P = 0.830, 0.711 and 0.802, respectively). According to the Rome Ⅱ standard classification, 82 cases (67.77%) of ulcer type, 34 cases of dyskinesia (28.10%) and 5 cases (4.13%) of non-specific type. According to Rome III standard classification, EPS was 75.32% (119/158), only 15.82% (25/158) were eligible for postprandial PDS, and 8.86% (14/158) were eligible for PDS and EPS. ④ According to Rome Ⅱ and Rome Ⅲ standard diagnosis of FD patients, abdominal pain, abdominal distension, early fullness, fullness after eating, abdominal fullness, abdominal burning, heartburn, nausea, vomiting, acid reflux, belching, loss of appetite (P <0.05). The incidence of upper abdominal discomfort in patients with FD was higher than that of patients with Rome Ⅲ (P = 0.012). ⑤ Patients in the two groups had lower gastrointestinal symptoms in 11.57% (14/121) and 13.92% (22/158) patients, respectively, with no significant difference between the two groups (P = 0.561). Conclusion The diagnosis rate of FD in Rome Ⅲ is higher than that of Rome Ⅱ, and Rome Ⅲ is more suitable for operation and evaluation. In the general situation of patients and clinical information such as the two standards there was no significant difference. Due to the small sample size, the conclusions need to be further evaluated.