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目的分析上海地区消化不良症状特点,以提高消化不良的处理水平。方法连续调查782例消化不良患者,包括功能性消化不良(FD)和器质性消化不良患者(OD)的症状特点,患者填写调查表(包括12项消化不良症状),并根据症状程度进行评分,分析症状与进餐等因素的关系。结果782例消化不良患者中,FD543例(69.4%),OD239例(30.6%),OD组男性比例高于FD组。两组患者平均症状积分差异无统计学意义(21.5比20.4,P>0.05),但OD组上腹痛和饥饿痛的积分高于FD组(2.65±1.11比2.16±0.92,2.26±1.26比1.79±0.92,P值均<0.05)。OD和FD组中分别有45.2%和47.7%的患者症状与进餐无关;FD组溃疡样型、动力障碍样型和非特异型中分别有59.6%、50.9%和35.2%的患者症状与进餐无关。2.5%(6/239)的OD患者出现进行性吞咽困难,2.8%(15/543)的FD患者出现间歇性吞咽困难。8.8%(21/239)的OD患者出现体重显著减轻,同时伴有其他报警症状;而5.9%(32/543)的FD患者发生此症状,但均不伴有其他报警症状。13.8%的FD患者在随访1年中出现FD亚型间的转换。此外,OD患者幽门螺杆菌(Hp)阳性率(53.1%)显著高于FD(42.2%,P<0.01),FD亚型组间Hp感染率差异无统计学意义(P>0.05),OD和FD患者中Hp阳性者口臭症状发生率显著高于Hp阴性者(44.9%比17.0%,47.3%比25.4%,P值均<0.0
Objective To analyze the characteristics of dyspeptic symptoms in Shanghai in order to improve the treatment of indigestion. Methods A total of 782 patients with dyspepsia, including functional dyspepsia (FD) and organic dyspepsia (OD), were included in the survey. Patients completed a questionnaire (including 12 indigestion symptoms) and were scored according to their symptoms , Analysis of the relationship between symptoms and eating and other factors. Results Among 782 patients with dyspepsia, FD543 cases (69.4%) and OD239 cases (30.6%) were higher in OD group than in FD group. There was no significant difference in average symptom scores between the two groups (21.5 vs 20.4, P> 0.05), but the scores of upper abdominal pain and hunger pain in OD group were higher than those in FD group (2.65 ± 1.11 vs 2.16 ± 0.92, 2.26 ± 1.26 vs 1.79 ± 0.92, P <0.05). The symptoms of 45.2% and 47.7% of patients in OD and FD groups were independent of meal intake. The symptoms of FD group were 59.6%, 50.9% and 35.2% in ulcer-like, motility-deficient and nonspecific groups respectively . Progressive dysphagia occurred in 2.5% (6/239) of OD patients and intermittent dysphagia in 2.8% (15/543) of FD patients. In 8.8% (21/239) of OD patients, there was significant weight loss accompanied by other warning symptoms; 5.9% (32/543) of FD patients developed this symptom but none of the other symptoms were reported. In 13.8% of FD patients, there was a transition between FD subtypes during one year of follow-up. In addition, the positive rate of Helicobacter pylori (Hp) in OD patients was significantly higher than that in FD patients (42.2%, P <0.01). There was no significant difference in Hp infection rate among OD patients (P> 0.05) The incidence of halitosis was significantly higher in Hp-positive FD patients than in Hp-negative patients (44.9% vs. 17.0%, 47.3% vs. 25.4%, P <0.0