上消化道功能性疾病临床特点分析

背景：了解上消化道功能性疾病（UFDs）与上消化道器质性疾病（UODs）临床特点的差异,有助于临床医师诊断思路的形成。目的：分析UFDs的临床特点。方法：对2006年7～8月因消化不良于武汉协和医院接受上消化道内镜检查者行连续问卷调查。UFDs的诊断参照罗马Ⅲ标准。结果：UFDs中女性所占比例显著高于UODs（P=0.000）,恶性肿瘤中男性所占比例显著高于UFDs（P=0.000）。恶性肿瘤和良性UODs发病年龄显著高于UFDs（P=0.000和P=0.026）。各年龄段消化不良患者中均以良性UODs所占比例最高,UFDs比例在65岁前基本呈下降趋势,恶性肿瘤则在35岁后大致呈上升趋势。功能性消化不良（FD）上腹烧灼感、上腹不适、反酸、嗳气、烧心发生率显著低于糜烂溃疡性胃十二指肠疾病（P〈0.05）,早饱、腹胀、上腹不适、上腹饱胀、呕吐、食欲下降发生率显著低于胃十二指肠肿瘤（P〈0.05）。UFDs可出现消瘦、贫血和吞咽困难症状,但发生率显著低于恶性肿瘤（P〈0.01）。结论：UFDs与UODs在性别、发病年龄、消化不良症状、报警症状等方面均有明显差异,细致分析其临床特点可为诊断和鉴别诊断提供思路。

Analysis of Clinical Characteristics of Upper Gastrointestinal Functional Disorders

Background： Understanding the difference of clinical characteristics between upper gastrointestinal functional disorders （UFDs） and upper gastrointestinal organic diseases （UODs） may contribute to the diagnostic thoughtfulness of these two diseases. Aims： To analyze the clinical characteristics of UFDs. Methods： Consecutive dyspeptic patients undergoing upper gastrointestinal endoscopy from July to August 2006 in Wuhan Union Hospital were enrolled and asked for filling up the questionnaires. UFDs were diagnosed according to Rome Ⅲ criteria. Results： There were more females in UFDs than in UODs （P=0.000）,whereas more males in malignant UODs than in UFDs （P=0.000）. The ages of onset of malignant and benign UODs were significantly higher than that of UFDs （P=0.000 and 0.026,respectively）. Among dyspeptic patients of any age group,the percentage of benign UODs was the highest. The percentage of UFDs had a tendency to decline before 65 years of age,while the incidence of malignant UODs increased after 35 years of age. The frequencies of epigastric burning,epigastric discomfort,acid regurgitation,belching and heartburn in functional dyspepsia （FD） were significantly lower than those in erosive and ulcerative gastroduodenal diseases （P〈0.05）,and the frequencies of early satiety,abdominal distention,epigastric discomfort,epigastric fullness,vomiting and decrease of appetite in FD were significantly lower than those in gastroduodenal tumors （P〈0.05）. UFDs patients might have weight loss,anemia and dysphagia,but the frequencies were significantly lower than those in malignant UODs （P〈0.01）. Conclusions： Obvious differences occur in gender,age of onset,dyspeptic symptoms and alarm symptoms between UFDs and UODs. Analysis of clinical characteristics may provide thoughtfulness in the diagnosis and differential diagnosis of these diseases.