Diagnostic yield of alarm features in irritable bowel syndrome and functional dyspepsia
Diagnostic yield of alarm features in irritable bowel syndrome and functional dyspepsia
复制标题
DOI：
10.1136/gut.2003.021857
复制
发表时间：
2004-05-01
期刊：
影响因子：
24.5
通讯作者：
Talley, NJ
中科院分区：
文献类型：
--
作者：
Hammer, J;Eslick, GD;Talley, NJ
目标：在区分功能性和器质性胃肠道疾病时，增加报警症状的诊断价值仍不确定。我们的目的是建立价值报警功能在区分器质性疾病和肠易激综合征（IBS）和功能性消化不良（FD）。方法：共568例连续患者（63%女性，平均年龄44.7岁）完成了详细的症状问卷，然后接受了完整的诊断检查，按要求。前瞻性收集问卷数据并进行回顾性稽查;治疗医生对问卷结果不知情。对患者进行编码并分配至以下诊断组：IBS、FD、上消化道器质性疾病或下消化道器质性疾病。逻辑回归用于确定区分器质性疾病和功能性疾病的最佳症状子集。单独的模型将IBS（n = 214）与下消化道疾病（n = 66）以及FD（n = 70）与上消化道疾病（n = 250）进行比较。（症状发作时50岁：比值比（OR）2.65（95%置信区间1.4-5.0）; p = 0.002）和卫生纸上的血（OR 2.7（1.4-5.1）; p = 0.002）作为区分IBS和下消化道疾病的报警特征出现。IBS的诊断通常与女性（OR 2.5（1.3-4.6）; p = 0.004）、前一年有6次或6次以上的疼痛（OR 5.0（2.2-11.1）; p = 0.004）有关
Objective: The diagnostic value of the addition of alarm symptoms in distinguishing functional from organic gastrointestinal disease remains uncertain. We aimed to establish the value of alarm features in differentiating between organic disease and irritable bowel syndrome (IBS) and functional dyspepsia (FD).Methods: A total of 568 consecutive patients (63% female; mean age 44.7 years) completed a detailed symptom questionnaire and then received a complete diagnostic workup, as required. Questionnaire data were collected prospectively and audited retrospectively; the treating physician was blinded to the results of the questionnaires. Patients were coded and allocated to the following diagnostic groups: IBS, FD, organic diseases of the upper gastrointestinal tract, or organic diseases of the lower gastrointestinal tract. Logistic regression was used to identify the best subset of symptoms that discriminated organic disease from functional illness. Separate models compared IBS (n = 214) with diseases of the lower gastrointestinal tract (n = 66), and FD (n = 70) with diseases of the upper gastrointestinal tract (n = 250).Results: Age (50 years at symptom onset: odds ratio (OR) 2.65 (95% confidence interval 1.4-5.0); p = 0.002) and blood on the toilet paper (OR 2.7 (1.4-5.1); p = 0.002) emerged as alarm features that discriminated IBS from lower gastrointestinal illness. A diagnosis of IBS was typically associated with female sex (OR2.5 (1.3-4.6); p = 0.004), pain on six or more occasions in the previous year (OR 5.0 (2.2-11.1); p