Talley N J, Zinsmeister A R, Schleck C D, Melton L J
Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota.
Gastroenterology. 1992 Apr;102(4 Pt 1):1259-68.
It has been proposed that patients with dyspepsia can be classified into symptom groupings that may represent different pathophysiological entities; however, it remains to be shown that distinct symptom subgroups exist. To estimate the prevalence of dyspepsia (defined as upper abdominal pain) and dyspepsia subgroups, an age- and sex-stratified random sample of Olmsted County, Minnesota, residents, aged 30-64 years, were mailed a valid self-report questionnaire; 82% responded (n = 835). Subgroups were as follows: those with symptoms suggestive of peptic ulceration (ulcerlike dyspepsia), those with gastric stasis (dysmotilitylike dyspepsia), those with gastroesophageal reflux (refluxlike dyspepsia), and the remainder (unspecified dyspepsia). Ulcerlike dyspepsia was the commonest subgroup (prevalence, 16.0/100; 95% confidence interval, 13.4-18.5), but 43% of subjects with dyspepsia could be classified into more than one subgroup. Nearly one third of dyspeptics also had irritable bowel symptoms, but these were not confined to any particular dyspepsia subgroup. Although dyspepsia is very common in the community and the majority have ulcerlike symptoms, there is such overlap among the dyspepsia subgroups that a classification based on symptoms alone in uninvestigated patients may not be useful.
有人提出，消化不良患者可分为可能代表不同病理生理实体的症状分组；然而，不同症状亚组的存在仍有待证实。为了估计消化不良（定义为上腹部疼痛）和消化不良亚组的患病率，对明尼苏达州奥尔姆斯特德县30 - 64岁的居民按年龄和性别分层进行随机抽样，并向他们邮寄了一份有效的自我报告问卷；82%的人做出了回应（n = 835）。亚组如下：有消化性溃疡症状提示的患者（溃疡样消化不良）、有胃潴留的患者（动力障碍样消化不良）、有胃食管反流的患者（反流样消化不良）以及其余患者（未分类的消化不良）。溃疡样消化不良是最常见的亚组（患病率为16.0/100；95%置信区间为13.4 - 18.5），但43%的消化不良患者可被归类到不止一个亚组。近三分之一的消化不良患者也有肠易激综合征症状，但这些症状并不局限于任何特定的消化不良亚组。虽然消化不良在社区中非常常见，且大多数人有溃疡样症状，但消化不良亚组之间存在如此多的重叠，以至于在未经调查的患者中仅基于症状进行分类可能并无用处。
