Hillilä M T, Färkkilä M A
Department of Medicine, Division of Gastroenterology, Helsinki University Central Hospital, Helsinki, Finland.
Aliment Pharmacol Ther. 2004 Aug 1;20(3):339-45. doi: 10.1111/j.1365-2036.2004.02034.x.
Prevalence of irritable bowel syndrome shows great variation among epidemiological studies, which may be due to different diagnostic criteria.
To assess prevalence of irritable bowel syndrome according to various diagnostic criteria and to study differences in symptom severity, psychopathology, and use of health care resources between subjects fulfilling different diagnostic criteria.
A questionnaire was mailed to 5000 randomly selected adults. Presence of irritable bowel syndrome was assessed by four diagnostic criteria: Manning 2 (at least two Manning symptoms), Manning 3 (at least three Manning symptoms), Rome I and Rome II.
Response rate was 73%. Prevalence of irritable bowel syndrome by Manning 2, Manning 3, Rome I and Rome II criteria was 16.2%, 9.7%, 5.6%, and 5.1% respectively. Of those fulfilling Rome II criteria, 97% fulfilled Manning 2. Severe or very severe abdominal pain was reported by 27-30% of Manning-positive subjects, and 44% of Rome-positives. Prevalence of depression in Manning 2, and Rome II groups was 30.6 and 39.3%.
Prevalence of irritable bowel syndrome by Rome II criteria is considerably lower than by Manning criteria. Subjects fulfilling Rome criteria form a subgroup of Manning-positive subjects with more severe abdominal symptoms, more psychopathology, and more frequent use of the health care system.
肠易激综合征的患病率在流行病学研究中差异很大,这可能是由于诊断标准不同所致。
根据各种诊断标准评估肠易激综合征的患病率,并研究符合不同诊断标准的受试者在症状严重程度、精神病理学以及医疗资源使用方面的差异。
向5000名随机选取的成年人邮寄了一份问卷。通过四种诊断标准评估肠易激综合征的存在情况:曼宁标准2(至少两种曼宁症状)、曼宁标准3(至少三种曼宁症状)、罗马标准I和罗马标准II。
回复率为73%。根据曼宁标准2、曼宁标准3、罗马标准I和罗马标准II,肠易激综合征的患病率分别为16.2%、9.7%、5.6%和5.1%。在符合罗马标准II的受试者中,97%符合曼宁标准2。27% - 30%的曼宁阳性受试者报告有严重或非常严重的腹痛,而罗马阳性受试者中这一比例为44%。曼宁标准2组和罗马标准II组的抑郁症患病率分别为30.6%和39.3%。
根据罗马标准II,肠易激综合征的患病率明显低于曼宁标准。符合罗马标准的受试者构成了曼宁阳性受试者的一个亚组,这些受试者有更严重的腹部症状、更多的精神病理学问题以及更频繁地使用医疗系统。