Prevalence of celiac disease in adult Chinese patients with diarrhea-predominant irritable bowel syndrome: A prospective, controlled, cohort study
Prevalence of celiac disease in adult Chinese patients with diarrhea-predominant irritable bowel syndrome: A prospective, controlled, cohort study
复制标题
中国成人腹泻型肠易激综合征患者乳糜泻的患病率：一项前瞻性对照队列研究
DOI：
10.1111/1751-2980.12587
复制
发表时间：
2018-03-01
影响因子：
3.5
通讯作者：
Li, Yan Qing
中科院分区：
文献类型：
--
作者：
Kou, Guan Jun;Guo, Jing;Li, Yan Qing
目的腹腔疾病是一种慢性炎症性肠病，其症状类似于肠易激综合征(IBS)。在西方国家，这是一种常见但在很大程度上没有确诊的疾病。然而，它在中国人中极其罕见，很少有研究调查其在中国中的患病率。本研究的目的是在中国北方某中心采用罗马III标准确定IBS患者的乳糜泻患病率。方法本研究是齐鲁医院进行的一项单中心前瞻性对照队列研究，包括246例IBS患者和246名健康对照。抽血检测血清组织转谷氨酰胺酶免疫球蛋白A(TTG-IgA)。结果12例(4.9%)IBS患者和2例(0.8%)健康体检者血清TTG-IgA阳性或可疑。在这些患者中，5名IBS患者接受了pCLE和靶向活检；组织病理学发现所有患者都患有乳糜泻，尽管其中一人最终被诊断为淋巴瘤。在实施无面筋饮食后，7名血清IBS阳性的患者临床症状有所改善，因此我们的研究显示，在本中心IBS患者中，乳糜泻的最低患病率为2.85%。结论腹腔病在中国人中并不罕见，尤其是在IBS患者中。因此，在中国的临床实践中应给予更高的重视。
ObjectiveCeliac disease is a chronic inflammatory enteropathy with a symptom spectrum similar to that of irritable bowel syndrome (IBS). It is a common but largely undiagnosed condition in the Western countries. However, it is extremely rare among Chinese individuals, and few studies have investigated its prevalence in China. The aim was to determine the prevalence of celiac disease in patients with IBS who were diagnosed using the Rome III criteria in a single center of northern China.MethodsThis was a single-center, prospective, controlled cohort study performed in Qilu Hospital involving 246 patients with IBS and 246 healthy controls. Blood samples were drawn to assess serum tissue transglutaminase immunoglobulin A (tTg-IgA). Patients with a positive or equivocal tTg-IgA (15 U/mL) were subjected to probe-based confocal laser endomicroscopy (pCLE) and duodenal biopsy to confirm celiac disease.ResultsAltogether 12 (4.9%) patients with IBS and two (0.8%) healthy controls were positive or equivocal for serum tTg-IgA. Of these, five patients with IBS underwent pCLE and a targeted biopsy; all were histopathologically found to have celiac disease, although one was eventually diagnosed with lymphoma. After implementation of a gluten-free diet, seven patients serologically positive for IBS showed clinical improvement, thus our study illustrated a minimum prevalence of 2.85% of celiac disease among patients with IBS in our center.ConclusionsCeliac disease is not rare in Chinese individuals, particularly among those with IBS. Therefore, it should receive higher attention in clinical practice in China.