Systematic review and meta-analysis: the incidence and prognosis of post-infectious irritable bowel syndrome
Systematic review and meta-analysis: the incidence and prognosis of post-infectious irritable bowel syndrome
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DOI：
10.1111/j.1365-2036.2007.03399.x
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发表时间：
2007-08-15
影响因子：
7.6
通讯作者：
Marshall, J. K.
中科院分区：
文献类型：
--
作者：
Thabane, M.;Kottachchi, D. T.;Marshall, J. K.
背景个别研究表明，感染后肠易激综合征是常见的，但症状逐渐改善。评估感染后肠易激综合征的预后，并探讨增加风险的因素。（1966-2007）和EMBASE（1980-2007）数据库进行检索，以确定感染后肠易激综合征流行病学的研究。数据由两名独立审查员提取。合并优势比（POR）和相应的95%CI肠易激综合征的发病率估计之间的暴露和未暴露groups.Results18的26项研究确定有资格列入。肠道感染与研究结束时发生肠易激综合征的几率增加相关（POR = 5.86; 95%CI：3.60-9.54）。在亚组分析中，3个月时发生肠易激综合征的几率增加（POR = 7.58; 95% CI：4.27-13.45），6个月（POR = 5.18; 95% CI：3.24-8.26）、12个月（POR = 6.37; 95% CI：2.63-15.40）和24-36个月（POR = 3.85; 95% CI：2.95-5.02）。在所有研究（对照和非对照）中，研究结束时肠易激综合征的汇总发生率为10%（95% CI：9.4-85.6）。感染后肠易激综合征的受试者比没有感染后肠易激综合征的受试者更年轻、更焦虑和抑郁。结论急性胃肠道感染后患肠易激综合征的几率增加了六倍。年轻、长期发热、焦虑和抑郁是感染后肠易激综合征的危险因素。
BackgroundIndividual studies suggest that post-infectious irritable bowel syndrome is common, but symptoms gradually improve.AimTo review evidence for an association between intestinal infection and development of irritable bowel syndrome, assess the prognosis of post-infectious irritable bowel syndrome and explore factors that increase the risk.MethodsMEDLINE (1966-2007) and EMBASE (1980-2007) databases were searched to identify the studies of post-infectious irritable bowel syndrome epidemiology. Data were extracted by two independent reviewers. Pooled odds ratios (POR) and corresponding 95% Cl for incidence of irritable bowel syndrome were estimated among the exposed and unexposed groups.ResultsEighteen of 26 studies identified were eligible for inclusion. Intestinal infection was associated with increased odds of developing irritable bowel syndrome at study end (POR = 5.86; 95% Cl: 3.60-9.54). In subgroup analysis, the odds of developing irritable bowel syndrome was increased at 3 months (POR = 7.58; 95% Cl: 4.27-13.45), 6 months (POR = 5.18; 95% Cl: 3.24-8.26), 12 months (POR = 6.37; 95% Cl: 2.63-15.40) and 24-36 months (POR = 3.85; 95% Cl: 2.95-5.02). Among all studies (controlled and uncontrolled), the pooled incidence of irritable bowel syndrome at study conclusion was 10% (95% Cl: 9.4-85.6). Subjects with post-infectious irritable bowel syndrome were younger and more anxious and depressed than those without post-infectious irritable bowel syndrome.ConclusionThe odds of developing irritable bowel syndrome are increased sixfold after acute gastrointestinal infection. Young age, prolonged fever, anxiety and depression are risk factors for post-infectious irritable bowel syndrome.