马来族人群肠易激综合征的 Rome III 调查
Rome III survey of irritable bowel syndrome among ethnic Malays.
机构信息
Department of Medicine, School of Medical Sciences, University Sains Malaysia, Kubang Kerian 16150, Malaysia.
出版信息
World J Gastroenterol. 2012 Nov 28;18(44):6475-80; discussion p. 6479. doi: 10.3748/wjg.v18.i44.6475.
AIM
To survey irritable bowel syndrome (IBS) using Rome III criteria among Malays from the north-eastern region of Peninsular Malaysia.
METHODS
A previously validated Malay language Rome III IBS diagnostic questionnaire was used in the current study. A prospective sample of 232 Malay subjects (80% power) was initially screened. Using a stratified random sampling strategy, a total of 221 Malay subjects (112 subjects in a "full time job" and 109 subjects in "no full time job") were recruited. Subjects were visitors (friends and relatives) within the hospital compound and were representative of the local community. Red flags and psychosocial alarm symptoms were also assessed in the current study using previously translated and validated questionnaires. Subjects with IBS were sub-typed into constipation-predominant, diarrhea-predominant, mixed type and un-subtyped. Univariable and multivariable analyses were used to test for association between socioeconomic factors and presence of red flags and psychosocial alarm features among the Malays with IBS.
RESULTS
IBS was present in 10.9% (24/221), red flags in 22.2% (49/221) and psychosocial alarm features in 9.0% (20/221). Red flags were more commonly reported in subjects with IBS (83.3%) than psychosocial alarm features (20.8%, P < 0.001). Subjects with IBS were older (mean age 41.4 years vs 36.9 years, P = 0.08), but no difference in gender was noted (P = 0.4). Using univariable analysis, IBS was significantly associated with a tertiary education, high individual income above RM1000, married status, ex-smoker and the presence of red flags (all P < 0.05). In multiple logistic regression analysis, only the presence of red flags was significantly associated with IBS (odds ratio: 0.02, 95%CI: 0.004-0.1, P < 0.001). The commonest IBS sub-type was mixed type (58.3%), followed by constipation-predominant (20.8%), diarrhea-predominant (16.7%) and un-subtyped (4.2%). Four of 13 Malay females (30.8%) with IBS also had menstrual pain. Most subjects with IBS had at least one red flag (70.8%), 12.5% had two red flags and 16.7% with no red flags. The commonest red flag was a bowel habit change in subjects > 50 years old and this was reported by 16.7% of subjects with IBS.
CONCLUSION
Using the Rome III criteria, IBS was common among ethnic Malays from the north-eastern region of Peninsular Malaysia.
目的
调查马来人肠易激综合征（IBS）使用罗马 III 标准在马来西亚半岛的东北地区。
方法
使用先前验证的马来语罗马 III IBS 诊断问卷在当前研究中。最初对 232 名马来人进行了前瞻性筛查（80%的概率）。采用分层随机抽样策略，共招募了 221 名马来人（112 名“全职工作”和 109 名“非全职工作”）。研究对象是医院内的访客（朋友和亲戚），代表了当地社区。在当前研究中，还使用先前翻译和验证的问卷评估了红色标记和心理社会报警症状。根据罗马 III 标准，将 IBS 患者分为便秘为主型、腹泻为主型、混合型和未分型。采用单变量和多变量分析测试社会经济因素与马来人 IBS 患者中红色标记和心理社会报警特征之间的关系。
结果
221 名马来人中，IBS 发生率为 10.9%（24/221），红色标记发生率为 22.2%（49/221），心理社会报警特征发生率为 9.0%（20/221）。IBS 患者中红色标记的报告更为常见（83.3%），而心理社会报警特征（20.8%）更为常见（P<0.001）。IBS 患者年龄较大（平均年龄 41.4 岁 vs. 36.9 岁，P=0.08），但性别差异无统计学意义（P=0.4）。单变量分析显示，IBS 与高等教育、个人收入超过 RM1000、已婚、前吸烟者和红色标记的存在显著相关（均 P<0.05）。多元逻辑回归分析显示，只有红色标记的存在与 IBS 显著相关（比值比：0.02，95%CI：0.004-0.1，P<0.001）。最常见的 IBS 亚型为混合型（58.3%），其次是便秘型（20.8%）、腹泻型（16.7%）和未分型（4.2%）。13 名马来族女性 IBS 患者中有 4 名（30.8%）也有经期疼痛。大多数 IBS 患者至少有一个红色标记（70.8%），12.5%有两个红色标记，16.7%没有红色标记。最常见的红色标记是>50 岁人群的排便习惯改变，IBS 患者中有 16.7%报告了这种情况。
结论
使用罗马 III 标准，马来人肠易激综合征在马来西亚半岛东北部地区很常见。
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