Lack of discriminant value of dyspepsia subgroups in patients referred for upper endoscopy.
Lack of discriminant value of dyspepsia subgroups in patients referred for upper endoscopy.
复制标题
对于转诊接受上消化道内窥镜检查的患者来说，消化不良亚组缺乏区分价值。
DOI：
10.1016/0016-5085(93)90142-y
复制
发表时间：
1993
期刊：
影响因子：
29.4
通讯作者：
A. Zinsmeister
中科院分区：
文献类型：
--
作者：
N. Talley;A. Weaver;Dixie L Tesmer;A. Zinsmeister
背景资料：将未确诊的消化不良患者细分为有症状的亚组（溃疡样、运动障碍样、反流样和非特异性）可能会提供潜在原因的线索;然而，这种方法在实践中的价值尚不清楚。本研究旨在确定消化不良症状和这些症状的组合的判别值。研究方法：820例门诊患者（中位年龄62岁; 47%为男性）的连续样本在内镜检查前完成了一份有效的问卷，测量了46种胃肠道症状。结果如下：在功能性消化不良患者（n= 162）中，17%为溃疡样消化不良，9%为运动障碍样消化不良，16%为反流样消化不良; 31%分为两个或两个以上的症状亚组; 27%为非特异性症状。在无功能性消化不良的患者中观察到消化不良亚组的相似分布。与所有其他诊断相比，年龄较小、女性、频繁的上腹痛、使用抗酸剂不能（或有时）缓解疼痛以及不经常呕吐是功能性消化不良的预测因素（特异性为80%，灵敏度为60%）。在功能性消化不良与所有其他诊断的单独模型中，消化不良亚组的鉴别力较差（特异性为80%，灵敏度仅为43%）。结论：目前定义的消化不良亚组似乎没有什么临床实用性，可能是一种不适当的消化不良分类方法。
Background: The subdivision of undiagnosed patients with dyspepsia into symptomatic subgroups (ulcerlike, dysmotilitylike, refluxlike, and nonspecific) may give a clue to the underlying cause; however, the value of this approach in practice is unclear. This study aimed to determine the discriminant value of dyspeptic symptoms and combinations of these symptoms. Methods: A consecutive sample of 820 outpatients (median age, 62 years; 47% male) completed, before endoscopy, a validated questionnaire that measured 46 gastrointestinal symptoms. Results: Of patients with functional dyspepsia (n= 162), 17% had ulcerlike, 9% dysmotilitylike, and 16% refluxlike dyspepsia alone; 31% fell into two or more symptom subgroups; and 27% had nonspecific symptoms. A similar distribution of the dyspepsia subgroups was observed in patients without functional dyspepsia. Younger age, female gender, frequent upper abdominal pain, no (or sometimes) pain relief with antacid use, and infrequent vomiting were predictive of functional dyspepsia vs. all other diagnoses (at a specificity of 80%, the sensitivity was 60%). The dyspepsia subgroups were poor discriminators in a separate model for functional dyspepsia vs. all other diagnoses (at a specificity of 80%, the sensitivity was only 43%). Conclusions: The dyspepsia subgroups, as currently defined, appear to have little clinical utility and may be an inappropriate way of classifying dyspepsia.
影响因子：
39.2
作者：
TALLEY, NJ;PHILLIPS, SF;ZINSMEISTER, AR
通讯作者：
ZINSMEISTER, AR
消化不良和消化不良亚组：一项基于人群的研究。
影响因子：
29.4
作者：
Talley,NJ;Zinsmeister,AR;Schleck,CD;Melton3rd,LJ
通讯作者：
Melton3rd,LJ