Crean G P, Holden R J, Knill-Jones R P, Beattie A D, James W B, Marjoribanks F M, Spiegelhalter D J
Diagnostic Methodology Research Unit, Southern General Hospital, Glasgow.
Gut. 1994 Feb;35(2):191-202. doi: 10.1136/gut.35.2.191.
A prospective study of dyspepsia was carried out in a primary referral hospital between 1974-1987 including 1540 patients of whom 1433 were seen as outpatients. The study protocol was agreed in advance and a structured questionnaire was used to elicit relevant clinical information: up to three diagnoses were permitted for each patient. The commonest principal diagnoses were duodenal ulcer (26%), functional dyspepsia (22%), and irritable bowel syndrome (IBS) (15%); alcohol related dyspepsia (4%) was as common as gastric carcinoma or symptomatic gall stones. Multiple diagnoses were common (31% given two diagnoses, and 6% given three) so that in all 2111 diagnoses were given to 1540 patients; the functional disorders (IBS and functional dyspepsia) considered together accounted for 39% of all diagnoses made. Whereas organic conditions were diagnosed by clinicians with confidence (63-98% considered 'certain'), even when given as the principal or first diagnosis IBS was considered 'certain' in only 61% and functional dyspepsia 48%. The demographic symptom data, together with information on tobacco and alcohol use, and work lost are described in detail.
1974年至1987年间,在一家初级转诊医院对消化不良进行了一项前瞻性研究,共纳入1540例患者,其中1433例为门诊患者。研究方案事先已商定,并使用结构化问卷来获取相关临床信息:每位患者最多允许有三种诊断。最常见的主要诊断为十二指肠溃疡(26%)、功能性消化不良(22%)和肠易激综合征(IBS)(15%);酒精相关性消化不良(4%)与胃癌或有症状的胆结石发病率相当。多重诊断很常见(31%有两种诊断,6%有三种诊断),因此1540例患者共给出了2111种诊断;IBS和功能性消化不良这两种功能性疾病合计占所有诊断的39%。临床医生对器质性疾病的诊断很有信心(63% - 98%认为“确定”),即使作为主要或首个诊断,IBS被认为 “确定” 的仅为61%,功能性消化不良为48%。详细描述了人口统计学症状数据,以及关于烟草和酒精使用及误工的信息。