南亚农村社区的功能性消化不良、消化性溃疡和幽门螺杆菌感染：内镜辅助的家庭调查。

Functional Dyspepsia, Peptic Ulcer, and Helicobacter pylori Infection in a Rural Community of South Asia: An Endoscopy-Assisted Household Survey.

机构信息

Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh.

Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

出版信息

Clin Transl Gastroenterol. 2021 Apr 16;12(4):e00334. doi: 10.14309/ctg.0000000000000334.

DOI:10.14309/ctg.0000000000000334

PMID:33878048

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8052092/

Abstract

INTRODUCTION

Functional dyspepsia (FD), although commoner than organic dyspepsia (OD) in-hospital studies, community data, particularly from rural areas, are lacking. We performed a rural community study in Bangladesh with the primary aims to evaluate (i) the prevalence of uninvestigated dyspepsia (UD), FD, and OD and (ii) the risk factors for UD.

METHODS

This house-to-house survey was performed using a translated-validated enhanced Asian Rome III questionnaire and endoscopy with Helicobacter pylori tests, including genotyping.

RESULTS

Of 3,351/3,559 responders ([94.15%], age 40.41 ± 16.05 years, female 1924 [57.4%]), 547 (16.3%) had UD (female 346 [18%] vs male 201 [14%]; P = 0.002); 201 (6%), 88 (2.6%), and 258 (7.7%) had postprandial distress (PDS), epigastric pain syndromes (EPS) and PDS-EPS overlap, respectively. On multivariate analysis, age >50 years (adjusted odds ratio [AOR] 1.34 [1.07-1.68]), female sex (AOR 1.42 [1.17-1.74]), being married (AOR 1.57 [1.21-2.07]), lower family income (AOR 1.79 [1.43-2.26]), nonsteroidal anti-inflammatory drug use (AOR 7.05 [2.11-23.55]), previous acute gastroenteritis (AOR 5.42 [1.83-16]), and psychological distress (AOR 5.02 [2.87-8.76]) were risk factors for UD. Of 346/547 (63.25%) undergoing endoscopy, 232 (67.05%) and 114 (32.95%) had FD and OD (peptic ulcers [PU] 99 [28.61%] and erosive esophagitis 13 [3.76%]). About 53% of FD subjects had EPS-PDS overlap, 32% had PDS, and only 15% had EPS. H. pylori was detected in 266/342 (78%) dyspeptics (FD 173/230 [75.2%], vs OD 92/114 [82.1%], P = 0.169).

DISCUSSION

Sixteen percent, 11% and 5% of rural Bangladeshi Asian adults had UD, FD, and PU, respectively. One-third of UD subjects had OD, mostly PU.JOURNAL/cltg/04.03/01720094-202104000-00016/inline-graphic1/v/2021-04-15T161418Z/r/image-tiff.

摘要

简介

功能性消化不良（FD）虽然在住院研究中比器质性消化不良（OD）更为常见，但社区数据，特别是农村地区的数据却很缺乏。我们在孟加拉国的一个农村社区进行了一项研究，主要目的是评估（i）未经调查的消化不良（UD）、FD 和 OD 的患病率，以及（ii）UD 的风险因素。

方法

这项挨家挨户的调查使用了经过翻译验证的增强型亚洲罗马 III 问卷和内窥镜检查，包括幽门螺杆菌检测和基因分型。

结果

在 3351/3559 名应答者（[94.15%]，年龄 40.41±16.05 岁，女性 1924[57.4%]）中，有 547 人（16.3%）患有 UD（女性 346[18%] vs 男性 201[14%]；P=0.002）；201（6%）、88（2.6%）和 258（7.7%）人患有餐后不适（PDS）、上腹痛综合征（EPS）和 PDS-EPS 重叠。多变量分析显示，年龄>50 岁（调整后的优势比[OR]1.34[1.07-1.68]）、女性（OR 1.42[1.17-1.74]）、已婚（OR 1.57[1.21-2.07]）、较低的家庭收入（OR 1.79[1.43-2.26]）、非甾体抗炎药使用（OR 7.05[2.11-23.55]）、既往急性胃肠炎（OR 5.42[1.83-16]）和心理困扰（OR 5.02[2.87-8.76]）是 UD 的风险因素。在 547 名接受内镜检查的患者中，有 346 人（63.25%）进行了内镜检查，其中 232 人（67.05%）和 114 人（32.95%）患有 FD 和 OD（消化性溃疡[PU]99 例[28.61%]和糜烂性食管炎 13 例[3.76%]）。约 53%的 FD 患者存在 EPS-PDS 重叠，32%存在 PDS，只有 15%存在 EPS。在 342 名消化不良患者中，266 人（78%）检测到幽门螺杆菌（FD 患者中 173/230[75.2%]，OD 患者中 92/114[82.1%]，P=0.169）。