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一项关于肠易激综合征发病过程中儿童期创伤的病例对照研究。

A case-control study of childhood trauma in the development of irritable bowel syndrome.

作者信息

Halland M, Almazar A, Lee R, Atkinson E, Larson J, Talley N J, Saito Y A

机构信息

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

出版信息

Neurogastroenterol Motil. 2014 Jul;26(7):990-8. doi: 10.1111/nmo.12353. Epub 2014 May 11.

Abstract

BACKGROUND

The etiology of irritable bowel syndrome (IBS) is not been fully elucidated, but childhood trauma may disturb the brain-gut axis and therefore be important. Thus, we conducted a family based case-control study of IBS cases and their relatives with the aims to (i) determine the frequency of childhood trauma among IBS cases and controls as well as their relatives, and (ii) assess childhood trauma among IBS cases with affected relatives (familial IBS).

METHODS

Outpatients with IBS, matched controls, and their first-degree relatives completed a self-report version of Bremner' Early Trauma Inventory. Percent of cases and controls with a family history were compared and odds ratios were computed using chi-squared test; recurrence risks to relatives were computed using logistic regression and generalized estimating equations.

KEY RESULTS

Data were collected from 409 cases, 415 controls, 825 case relatives, and 921 control relatives. IBS cases had a median age of 50 and 83% were women. Of IBS cases, 74% had experienced any general trauma compared to 59% among controls, yielding an odds ratio of 1.56 (95% CI: 1.13-2.15, p < 0.008). There were no statistical differences between IBS relatives and control relatives with regards to lifetime trauma.

CONCLUSIONS & INFERENCES: IBS is associated with childhood trauma, and these traumas often occur prior to onset of IBS symptoms. This provides further insight into how traumatic childhood events are associated with development of adult IBS.

摘要

背景

肠易激综合征(IBS)的病因尚未完全阐明,但童年创伤可能会干扰脑-肠轴,因此具有重要意义。因此,我们对IBS患者及其亲属进行了一项基于家庭的病例对照研究,目的是:(i)确定IBS患者、对照者及其亲属中童年创伤的发生率;(ii)评估有患病亲属(家族性IBS)的IBS患者的童年创伤情况。

方法

IBS门诊患者、匹配的对照者及其一级亲属完成了Bremner早期创伤量表的自我报告版本。比较有家族病史的病例和对照的百分比,并使用卡方检验计算比值比;使用逻辑回归和广义估计方程计算亲属的复发风险。

主要结果

收集了409例患者、415例对照者、825例患者亲属和921例对照者亲属的数据。IBS患者的中位年龄为50岁,83%为女性。在IBS患者中,74%经历过任何一般性创伤,而对照者中这一比例为59%,比值比为1.56(95%CI:1.13-2.15,p<0.008)。IBS患者亲属和对照者亲属在终身创伤方面没有统计学差异。

结论与推论

IBS与童年创伤有关,这些创伤通常发生在IBS症状出现之前。这为童年创伤性事件与成人IBS的发展之间的关联提供了进一步的见解。

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