睡眠质量与社区人群肠易激综合征相关性分析

目的 探讨上海市社区人群睡眠质量与肠易激综合征(IBS)患病率及两者之间的关系.方法 采用随机分层整群抽样方法,对上海市嘉定区江桥镇常住人群成年居民进行面访式问卷调查,回收有效调查问卷11 569份.采用罗马Ⅲ标准诊断IBS,阿森斯睡眠障碍量表进行自我评估,分析睡眠障碍与IBS之间的关系.结果 睡眠障碍在社区总人群、IBS患者及非IBS患者中发生率分别为21.00%、33.02%和18.74%.IBS组存在睡眠障碍比例高于非IBS组,两组间差异有统计学意义(P=0.004,OR=2.14,95%CI:1.92～2.39),即存在睡眠障碍的人群患IBS的危险性是无睡眠障碍人群的2.14倍.在IBS组,女性患者存在睡眠障碍的比例(37.24%)显著高于男性患者(28.41%),两组间差异有统计学意义(P=0.000,OR=1.50,95%CI:1.23～1.82),提示存在睡眠障碍的女性更易于患IBS.Logistic回归分析显示睡眠障碍是IBS的危险因素之一(OR=2.11,95%CI:1.89～2.36).结论 IBS患者常存在睡眠障碍,尤其是女性患者.     

住院冠心病患者1083例心理状况的调查与相关分析

目的 探讨住院冠心病患者焦虑和抑郁症状的发生情况及相关因素.方法 采用现况调查研究,自2007年6月至2009年5月连续入选经冠状动脉造影诊断的住院冠心病患者.选用Zung焦虑自评量表(SAS)和抑郁自评量表(SDS)对入选患者进行心理测评,同时对受试者的经济状况、家庭情况、生活及工作场所环境等因素进行流行病学调查.统计学处理采用Student's t检验、卡方检验和多元逐步logistic回归分析.结果 共入选住院冠心病患者1083例,年龄(64.8±10.2)岁,其中男性863例,女性220例.单纯焦虑、单纯抑郁、焦虑合并抑郁的症状患病率分别为7.9%、28.3%和14.3%.女性患者焦虑、抑郁的症状患病率明显高于男性(29.5%比20.3%,P=0.003;50.0%比40.7%,P=0.012);老年(≥65岁)患者焦虑症状的患病率明显高于非老年患者(25.9%比17.9%,P=0.001);老年人、受教育年限少于9年、睡眠质量差与焦虑症状的发生显著相关,相应OR值分别为1.63(95%CI:1.21～2.21,P=0.002)、1.54(95%CI:1.15～2.07,P=0.004)和1.62(95%CI:1.34～1.96,P=0.000);长期工作地噪音、合并慢性疾病及睡眠质量差与抑郁症状的发生显著相关,OR值分别为1.52(95%CI:1.18～1.98,P=0.002)、1.36(95%CI:1.06～1.75,P=0.016)和1.27(95%CI:1.08～1.50,P=0.005);女性、老年人、长期工作地噪音、合并慢性疾病、睡眠质量差与焦虑合并抑郁症状的发生显著相关,OR值分别为1.91(95%CI:1.22～2.98,P=0.005)、1. 84(95%CI:1.23～2.76,P=0.003)、1.61(95%CI:1.07～2.42,P=0.022)、1.84(95%CI:1.24～2.71,P=0.002)和1.73(95%CI:1.35～2.21,P=0.000).结论 在住院冠心病患者中,约50%患者并发不同程度的焦虑和(或)抑郁症状,女性和老年患者是高发人群.受教育年限少于9年、合并慢性疾病、睡眠质量差、工作地噪音等与焦虑、抑郁症状的发生相关.     

东北地区军人肠易激综合征患者心理应激因素以及焦虑、抑郁情况调查

背景:肠易激综合征(IBS)的发病机制尚不清楚,社会心理因素被认为是其发病的重要原因,尤其是焦虑、抑郁与IBS的关系日益被关注。目的:调查东北地区军人IBS患者的心理应激因素以及焦虑、抑郁情况。方法:采用多级、分层、整群抽样方法选取东北地区11 400名军人,采用问卷调查进行IBS的调查,行Zung氏焦虑自评量表(SAS)和抑郁自评量表(SDS),分析焦虑、抑郁与应激因素的关系。结果:IBS的患病率为15.9%,IBS组焦虑、抑郁患病率分别为22.9%和26.6%,显著高于非IBS组的9.6%和12.4%(P0.05)。IBS组SAS、SDS评分分别为50.86±7.27和53.47±7.86,明显高于非IBS组的36.54±6.97和38.25±9.83(P0.05)。IBS患者的SAS评分和SDS评分均与感觉寂寞、情绪沮丧、训练强度大、工作压力大、与同事关系差、处置过突发事件或参加过军事演习等因素呈正相关(P0.05)。结论:军人这一特殊群体的IBS发生与应激和心理因素密切相关。     

增龄及肾小球滤过率下降对合肥市老年体检人群贫血患病率的影响

目的 探讨增龄及肾功能下降对合肥市老年体检人群贫血患病率的影响.方法 回顾性分析2005年1月-2007年12月在安徽省立医院体检中心体检的所有年龄大于60周岁的人群,进行贫血患病率调查,分析增龄、估算的肾小球滤过率(eGFR)下降与贫血患病率之间的关系.结果 在资料完整的4547例老年体检者中,贫血患病率为4.40%(95%CI:3.83%～5.05%),其中男性为4.04%(95%CI:3.37%～4.84%),女性为5.04%(95%CI:4.05%～6.24%).贫血患病率随年龄增加、eGFR降低而升高,差异均有统计学意义(P<0.001).多因素logistic回归分析发现,增龄、女性、eGFR降低的OR分别为2.507、1.758和1.741.结论 在合肥市老年体检人群中,贫血患病率为4.40%;增龄及肾小球滤过率下降是贫血患病率增加的独立危险因素. 在资料完整的4547例老年体检者中,贫血患病率为4.40%(95%CI:3.83%～5.05%),其中男性为4.04%(95%CI:3.37%～4.84%),女性为5.04%(95%CI:4.05%~6.24%).贫血患病率随年龄增加、eGFR降低而 高,差异均有统计学意义(P<0.001).多因素logistic回归分析发现,增龄、女性、eGFR降低的OR分别为2.507、1.758和1.741.结论 在合肥市老年体检人群中,贫血患病率为4.4     

汶川地震青川灾区老年人精神疾病流行病学调查

目的 了解汶川地震青川灾区老年人精神疾病患病情况.方法 分层随机抽取青川灾区城区和农村1 043例60岁以上老年人,使用自编<一般情况调查表>一般问卷12项(GHQ-12)以及(SCID-I/P)病人版为筛查和诊断工具.结果 调查对象中各种精神疾病患者178例,时点患病率17.1%,且女性显著高于男性(χ<'2>=8.42,P<0.01);农村显著高于城市(χ<'2>=26.50,P<0.01).各类精神疾病中以创伤后应激障碍的时点患病率最高50例(4.8%);焦虑障碍49例(4.7%);抑郁障碍38例(3.6%).老年人房屋是否受损垮塌与精神疾病有相关性(χ<'2>=3.94,P<0.05).结论 汶川地震青川灾区老年人存在明显的精神障碍,尤其是农村和女性,在进一步开展老年人心理卫生服务时应有针对性策略和措施.     

不同层次医学生肠易激综合征发病情况及其与精神因素的关系

目的了解不同层次医学生肠易激综合征(IBS)患病率及其与精神因素的关系。方法对同济医学院160名本科生和153名研究生进行问卷调查。采用胃肠道健康状况调查表,以罗马Ⅱ诊断标准作为IBS患病选择标准;抑郁自评表(SDS)、焦虑自评表(SAS)进行自我评定。结果(1)医学本科生中腹痛累计时间、腹痛程度、腹胀程度、大便异常累计时间评分高于硕士生(P<0.05);女生高于男生(P<0.05);(2)肠易激综合征的总患病率为13.42%,其中本科生为16.25%,硕士生为10.46%,男生12.26%,女生14.56%,但不同层次医学生、男女生之间比较差异均无显著性(P值分别为0.133和0.602);(3)不同层次医学生焦虑和抑郁情绪评分无显著差异(P>0.05),但女生抑郁评分高于男生(P=0.009);IBS相关症状累计时间与严重程度的评分均与心理测试评分呈显著正相关(P=0.000);达到IBS诊断标准的学生焦虑和抑郁的评分明显高于未达到诊断标准者(P=0.000)。结论医学本科生中IBS相关肠道症状发生率高于硕士生,但不同层次医学生肠易激综合征患病率无显著差异,肠易激综合征相关症状及发病与精神因素有关。     

社区老年冠心病患者并发抑郁的影响因素

目的 了解社区老年冠心病患者发生抑郁的危险因素,以便识别高危人群,为老年冠心病的防治提供科学依据.方法 采用自制一般情况调查问卷、汉密顿抑郁量表、社会支持评定量表对长沙市望月湖、陈家湖、广济桥3个社区老年冠心病患者进行入户调查.结果 ①332例研究对象中抑郁者152例,占45.8%,其中轻至中度抑郁者115例,占34.6%,重度抑郁者37例,占11.2%.≥70岁年龄组患病率高于≥60岁年龄组(P<0.05);②老年女性患病率高于男性(P<0.05);③女性文化程度低、日常生活中生活不能完全自理增加了患者的抑郁危险性(OR值分别为1.468,95%CI 1.094～2.835;2.154,95%CI 1.094～2.875;8.92,95%CI 3.820～22.172,均P<0.05);④社会支持方面:抑郁组主观支持分及对支持利用度分均明显低于非抑郁组(P<0.05).结论 社区老年冠心病患者抑郁发生率高,且与性别、文化程度、日常生活能力、社会支持等因素有关.     

老年体检人群代谢综合征伴焦虑及抑郁状态的现状调查

目的:了解本地区老年体检人群代谢综合征(MS)伴焦虑、抑郁状态的情况。方法:对大屯地区65岁以上老年体检人群进行疾病史、生化指标、焦虑自评量表(SAS)、抑郁自评量表(SDS)的测定,统计并分析。结果:876名老年体检人群中249人患代谢综合征,患病率为28.4%,其中:男性25.9%,女性30.1%,差异无统计学意义;MS人群焦虑、抑郁状态检出率为9.2%和2.4%;MS人群中不同性别、年龄和文化程度焦虑、抑郁状态检出率差异无统计学意义;MS人群与非MS人群焦虑、抑郁状检出率差异无统计学意义;女性MS人群SAS和SDS评分高于非代谢综合征人群,差异有统计学意义(t=2.04和2.324,P<0.05)。结论:大屯地区老年体检人群中MS患病率较高,MS伴焦虑、抑郁状态检出率相对较低,女性MS人群合并焦虑、抑郁状态的风险有所增加。     

肠易激综合征患者的睡眠特征

目的 分析伴焦虑抑郁和无焦虑抑郁的肠易激综合征(IBS)患者睡眠质量的差别,探讨IBS患者的睡眠特征.方法 采用pittsburgh睡眠质量指数量表(PSQI)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对IBS患者(145例)及健康体检志愿者(59例)进行问卷调查,再根据焦虑或抑郁评分对IBS患者分为无焦虑抑郁亚组和伴焦虑抑郁亚组,进行统计学分析.结果 在SAS、SDS量表中,IBS组的SAS粗分、SDS粗分及SAS粗分阳性率均比健康对照组高(29.43±15.24比26.10±11.55,31.29±13.32比26.51±13.91,12.41%比3.39%),差异均有统计学意义(P值均＜0.05),SDS粗分阳性率与健康对照组相比,差异无统计学意义(P＞0.05).在PSQI量表中,IBS组及无焦虑抑郁IBS亚组在睡眠质量、睡眠障碍、日间功能障碍等3个因子及PSQI总分比健康对照组高,差异有统计学意义(P＜0.05);伴焦虑抑郁的IBS亚组在睡眠质量、入睡时间、睡眠效率、睡眠障碍、睡眠时间、日间功能障碍等6个因子和PSQI总分比健康对照组高,差异有统计学意义(P＜0.05);伴焦虑抑郁的IBS亚组在所有7个因子和PSQI总分均比无焦虑抑郁的IBS亚组高,差异有统计学意义(P＜0.05).结论 IBS患者存在睡眠异常,主要表现在睡眠质量、睡眠障碍、日间功能障碍3个因子和PSQI总分异常,这些因子的异常独立于患者的情绪障碍,但情绪障碍会加重IBS患者的睡眠异常.     

西藏各地市健康人群H.pylori菌感染状况分析

目的了解目前西藏地区人群幽门螺旋杆菌(Helicobacter pylori, H. pylori)的感染状况,为西藏地区幽门螺杆菌感染的防治提供临床数据.方法回顾2017年于西藏自治区人民政府驻成都办事处医院就诊且同时完成13C-尿素呼气试验的西藏地区体检者,收集临床资料、常居留地及H. pylori检测结果等.结果共纳入931例病例, H. pylori总体阳性率为480/931(51.6%,95%C I:48.3%-54.8%),其中藏族586例, H.pylori阳性率为331/586(56.5%,95%CI:52.5%-60.5%);汉族345例, H.pylori阳性率为149/345(43.2%,95%CI:37.9%-48.4%).藏汉族之间H.pylori阳性率存在显著差异(P 0.001).西藏地区各地市的H. pylori阳性率分别为:拉萨市99/219(45.2%,95%C I:38.6%-51.8%),昌都市213/372(57.3%,95%C I:52.2%-62.3%),林芝市56/110(50.9%,95%CI:41.4%-60.4%),山南市25/63(39.7%,95%CI:27.3%-52.1%),日喀则市21/51(41.2%,95%C I:27.2%-55.2%),那曲地区17/40(42.5%,95%C I:26.5%-58.5%),阿里地区49/76(64.5%,95%C I:53.5%-75.5%),各地市之间的H.pylori阳性率存在差异(P=0.002).结论西藏地区H. pylori现患率已下降趋于全国水平,藏汉族之间现患率存在差异,各地市H. pylori现患率亦存在差异.     

A comparison of the Rome and Manning criteria for case identification in epidemiological investigations of irritable bowel syndrome

OBJECTIVE: The aim of this study was to estimate the prevalence of irritable bowel syndrome using different standard definitions (Rome and Manning criteria) and to determine the degree of agreement between these definitions. METHODS: A population-based, cross-sectional survey study was conducted by mailing a valid, reliable questionnaire to an age- and gender-stratified random sample of residents of Olmsted County, MN, aged 30-69 yr. The threshold for a positive diagnosis of irritable bowel was varied from two to four of the six Manning criteria and from two to three of the five defecation disorders in the Rome criteria. Unadjusted as well as age- and gender-adjusted prevalence rates were calculated for each of the five definitions of IBS. Percent agreement and kappa statistics were calculated to assess agreement between the definitions. RESULTS: Questionnaires were returned by 643 of 892 eligible subjects (72% response rate). The age- and gender-adjusted prevalence of IBS varied from 20.4% using a threshold of two symptoms in the Manning criteria to 8.5% using a threshold of three defecation disorders in the Rome criteria. The percent agreement for each comparison of Manning and Rome definitions was always >90%. The kappa values ranged from 0.55 to 0.78, with the best agreement occurring between a threshold of three symptoms of Manning and two defecation disorders in Rome. CONCLUSIONS: The prevalence of IBS varied substantially depending on the specific definition of IBS used. The range of prevalence estimates in Olmsted County was similar to other published figures when IBS definition was accounted for. These findings are useful in interpreting epidemiological and clinical studies of IBS.     

全国城市中小学生肠易激综合征现况调查

目的分析我国城市中小学生肠易激综合征（IBS）的患病率及分布特征。方法采用多级整群随机抽样方法,对我国六个省及两个直辖市中51956名中小学生进行流行病学问卷调查。结果全国符合Manning及罗马Ⅱ诊断标准IBS期间患病率分别为53．5％及20．2％,以高中生居多,男女患病率差异无统计学意义（P〉0．05）;南方地区患病率分别为53．3％及19．6％;北方地区患病率分别为51．2％及18．9％;西部地区患病率分别为58．0％及23．4％。结论IBS是城市中小学生的常见病及多发病,患病率随着年龄的增长而上升。     

Prevalence of irritable bowel syndrome in Korea: population-based survey using the Rome II criteria

BACKGROUND: Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder in the West. But information on the prevalence of IBS in Asia is still lacking, especially in Korea. Therefore, the aims of the present study were to estimate the prevalence of IBS in the general population of Korea and also to investigate characteristics of IBS and health-care-seeking behavior of IBS patients. METHODS: Telephone interview survey was conducted by Gallup, Korea using a validated questionnaire based on the Rome II criteria. The response rate of the telephone interview survey was 25.2% (n = 1066, 535 male and 531 female responders). A random sample of gender and age (between 18 and 60 years), based on a per capita ratio was obtained. RESULTS: Among 1066 subjects, the prevalence of IBS was 6.6% (70 subjects; 7.1%, male; 6.0%, female). The difference in IBS prevalence by gender was not significant. The prevalence was higher among those in their 20s (P = 0.036). Among 70 subjects with IBS, 10/20 IBS subjects sought health care due to abdominal pain. Among the risk factors of IBS, marital status had a significant difference; the following risk factors are arranged in descending order: age (odds ratio [OR]: 1.38, 95% confidence interval [CI]: 0.85-2.25), alcohol intake (OR: 1.38, 95%CI: 0.81-2.35), gender (OR: 1.19, 95%CI: 0.73-1.94), demographics (OR: 1.09, 95%CI: 0.53-2.25), income (OR: 0.88, 95%CI: 0.54-1.45), education level (OR: 0.81, 95%CI: 0.46-1.40), smoking (OR: 0.64, 95%CI: 0.37-1.12), and marital status (OR: 0.59, 95%CI: 0.35-0.99). CONCLUSIONS: The prevalence of IBS in the Korean population is 6.6%, and the male:female ratio is similar. Also, IBS is more frequent in younger subjects. Irritable bowel syndrome subjects visited a physician mostly due to abdominal pain.     

Increased prevalence of sicca complex and fibromyalgia in patients with irritable bowel syndrome

OBJECTIVE: As many as 70% of patients with fibromyalgia complain of the symptoms of irritable bowel syndrome (IBS), but there is a clinical impression that IBS patients do not suffer from fibromyalgia as frequently. The sicca complex (dry eyes and mouth) is also commonly observed in fibromyalgia, but its prevalence in IBS has not been evaluated. Our objective was to assess the frequency of fibromyalgia and sicca complex in secondary care patients with IBS. METHODS: Forty-six secondary care patients with IBS and 46 healthy controls were assessed by a rheumatologist for the presence of fibromyalgia and objective evidence of sicca complex (Schirmer and Rose-Bengal tests). Psychological status was also assessed (HAD questionnaire). RESULTS: Thirteen (28%) IBS patients suffered from fibromyalgia, compared with five (11%) controls, a difference of 17% (95% confidence intervals [CI], 2-33%). Fifteen (33%) IBS patients versus three (6%) controls had sicca complex, a difference of 27% (95% CI, 11-45%). CONCLUSIONS: These results suggest that the prevalence of fibromyalgia in IBS is approximately half that of IBS in fibromyalgia. Furthermore, sicca complex seems to be another complaint that should be added to the list of extracolonic manifestations of IBS. Study of the overlap between functional disorders presenting to different specialties may give new insights into the pathophysiology of these puzzling conditions.     

Irritable bowel syndrome in a rural community in Bangladesh: prevalence, symptoms pattern, and health care seeking behavior

OBJECTIVE: The aim of this study was to investigate the prevalence of irritable bowel syndrome (IBS) and the pattern of symptoms and health care seeking behavior of IBS subjects in the rural population in Bangladesh. METHODS: This was an observational study to do a positive diagnosis of IBS. A total of 2426 persons > or =15 yr old were interviewed by a predesigned questionnaire based on the Rome criteria. Two villages of a northern district in Bangladesh were included. RESULTS: A response of 95.4% yielded 2426 questionnaires for analysis. Mean age of the surveyed sample was 32.3+/-14.2 yr. In total, 1113 (45.9%) were men, and 1313 (54.1%) were women. Farmers and housewives comprised 2058 (84.8%) persons. The apparent prevalence of IBS was 24.4% with a prevalence of 20.6% in men and 27.7% in women. With strict Rome criteria, the overall prevalence was 8.5% (10.7% in women and 5.8% in men). Age was not found to influence the prevalence in either sex. Other than abdominal pain, the most common IBS symptom was altered stool passage (81.1%). Others in order of frequency were passage of mucus with stool (56.8%), abdominal distension (46.2%), altered stool form (46%), and altered stool frequency (18.2%). Spastic colon pain was noted in 339 (57.2%). IBS subjects with more prevalence of colonic symptoms in the nonspastic group. Drinking milk was found to have a little impact on IBS. A total of 35% IBS subjects consulted doctors for symptoms. Age, sex, and number of symptoms did not influence health care seeking behavior. CONCLUSIONS: IBS is also a problem in rural people in Bangladesh with a prevalence almost identical to most other countries, and only a minority of them seeks health care. Positive diagnosis of IBS can be done by precisely enquiring colonic symptoms in apparently healthy people.     

Prevalence of irritable bowel syndrome in Italian rural and urban areas

Background/aimsNo comparative studies are available, as yet, in Italy, concerning the prevalence of irritable bowel syndrome (IBS) in urban and rural areas. The aim is to compare the prevalence of IBS in Italian urban and rural areas.Methods950 subjects were randomly selected from each area and completed a questionnaire regarding demographic data and the Rome II questionnaire.ResultsThe prevalence of IBS was significantly (p < 0.05) higher in the urban (9.9%), than in the rural area (4.4%). In the urban area, a significantly higher prevalence of IBS was observed in females than in males, 67/490 (13.7%) vs 27/460 (5.9%) (p < 0.05), while no gender differences were present in the rural population.ConclusionIn the urban area, we found a higher prevalence of IBS, and a significantly higher prevalence of IBS in females than in males, while no gender differences were present in the rural population.     

Prevalence of irritable bowel syndrome in Hong Kong

BACKGROUND AND AIMS: As part of a public education program, the Hong Kong Society of Gastrointestinal Motility studied the prevalence of irritable bowel syndrome (IBS) in the community, which was based on the recently published Rome II criteria. The distribution of diarrhea or constipation-predominant IBS subtypes, the prevalence of bowel symptoms and the predictors of health-care seeking were also studied. METHODS: Among 1797 randomly selected respondents, 1000 successful telephone interviews (56%) were conducted from August 2000 to December 2000, using a validated questionnaire in Chinese that looked into demographic data and various bowel symptoms during the past year. RESULTS: The 12-month prevalence of IBS as defined by the Rome II criteria in Hong Kong was 6.6%. The female to male ratio was 1.3:1, but this ratio was the same in the control group. The distribution of IBS patients into diarrhea predominant, constipation predominant, and non-specific subtypes was 27, 17 and 56%, respectively. The predominant symptom in the IBS group was pain (54.5%), followed by urgency (15%), abdominal distension (15%) and diarrhea (11%). Forty-seven percent of IBS patients sought medical attention and only 21% of them knew that they had IBS. Moderate to severe pain severity (odds ratio 3.7, 95% CI 1.02-13) and mucus in stool (odds ratio 3.57, 95% CI 1.18-10.7) were associated with health-care seeking in univariate analysis. The prevalence of bowel symptoms such as urgency, straining, feeling of incomplete defecation, mucus in stool and abdominal distension ranged from 11 to 41%. CONCLUSION: The prevalence of IBS in Hong Kong was 6.6%, and the female to male ratio was similar to the control group. The majority was of non-specific IBS subtype. Gross underdiagnosis (21%) by Western practitioners was noted.