肠易激综合征患者的就医行为及其影响因素

目的探讨影响肠易激综合征（IBS）患者就医行为的因素。方法2009年采用整群、分层和随机抽样方法，在广州市、惠州市的8个城市社区和农村6个自然村中抽取常住城乡居民4000人进行面访式问卷调查，收集符合罗马Ⅱ诊断标准的IBS患者，记录其人口学资料、过去1年中的肠道症状、既往史、就医情况、生活事件及应对方式等。并将IBS患者分为就医组和未就医组，先后采用单因素和多因素分析，比较两组之间各影响因素的差异。结果共收集到符合罗马Ⅱ标准的IBS患者237例，其中53例因肠道症状就医过，就医率为22．4％。经过多因素分析并同时控制年龄、性别的影响后发现，就医偏好（OR=1．81，95％CI=1．27～2．58）、每次腹痛持续时间较长（OR=1．41，95％CI=1．01—5．14）及存在肠外症状（OR=2．14，95％CI=1．06～4．33）是影响IBS患者就诊的主要因素。结论IBS患者每次腹痛持续时间较长和肠外症状是影响其就医的因素，就医偏好对患者是否就医也有一定影响。

Correlates of health-care seeking behavior in patients with irritable bowel syndrome

Objective To explore correlates of health-care seeking behavior in patients with irritable bowel syndrome (IBS).Methods Four thousand permanent residents were recruited from eight urban communities and rural villages in Guangzhou and Huizhou, Guangdong province during 2009 by cluster stratified sampling for face-to-face questionnaire survey, including symptoms of bowel disease,behavior of seeking for health-care, demographic characteristics, coping style, life events and medical history.IBS was identified based on the Rome Ⅱ Criteria.Patient with IBS were divided into two groups,one seeking health-care at hospitals or clinics and the other non-seeking health-care.Univariate and multivariate logistic regression analysis was used to compare difference between the two groups and explore its related factors.Results A total of 237 IBS patients were identified based on the Rome Ⅱ Criteria, 53 of them (22.4% ) had sought health-care due to their symptoms.Results of multivariate logistic regression analysis showed that preference in seeking for health-care, abdominal pain lasting for more than one hour in each episode and extra-gastrointestinal symptoms were main factors related to their seeking for health-care,adjusted for age and gender, with odds ratios (ORs) of 1.81 (95% CI: 1.27 -2.58), 1.41 (95% CI:1.01 - 5.14 ) and 2.14 ( 95% CI: 1.06 - 4.33 ), respectively.Conclusions Extra-gastrointestinal symptoms and abdominal pain lasting for more than one hour in each episode correlate their health-care seeking behavior in patients with IBS, as well as their preferences in seeking for health-care.