摘要
目的筛查伴有血清学特征的成人乳糜泻在中国湖北人群特别是腹泻型肠易激综合征（D—IBS）患者中的患病情况。方法依据罗马Ⅲ标准选取282例D—IBS患者，并以296例年龄和性别匹配并且无腹泻症状的体检人群作为对照组，采用ELISA法检测血清IgA／IgG型抗人组织转谷氨酰胺酶／脱酰胺麸朊肽抗体（抗htTG／DGP）水平。血清抗体阳性者建议行去麸质饮食治疗5～6个月，观察临床疗效，并复查血清中抗htTG／DGP水平。结果纳入试验的578例研究对象中，血清抗htTG／DGP阳性7例，其中D—IBS组5例（5／282，1．77％），对照组2例（2／296，0．68％）。抗htTG／DGP阳性研究对象中，4例同意并进行了平均5．2个月的去麸质饮食治疗，随访观察显示其临床症状均得到明显改善，并伴随血清抗htTG／DGP水平降低。结论乳糜泻在中国可能并非罕见疾病，特别是在D—IBS患者乳糜泻发病率更高，因此，在IBS患者中进行乳糜泻血清学筛查具有重要意义。
Objective To screen the prevalence of celiac disease with serologic markers in the central Chinese population, specifically in patients with chronic diarrhea-predominant irritable bowel syndrome （D-IBS）. Methods A total of 282 adult patients with D-IBS were selected based on ROME ]II criteria with 296 age and sex matched consecutive healthy individuals as controls. A gluten-free diet （GFD） was advised in subjects positive for IgA/IgG anti-htTG/DGP antibodies and the serologic antibodies were retested after the GFD. Results Among the 578 study subjects, five D-IBS patients （5/282, 1.77% ） and two healthy controls （2/296, 0. 68% ） were positive for anti-htTG/DGP antibodies. Among the seven positive cases, one was lost to follow-up and only four were evaluated during GFD therapy for an average of 5.2 months with clinical and/or serological manifestations improved. Conclusions The prevalence of celiac disease may not be uncommon in China. Compared with the healthy population, patients with D-IBS tend to be affected more. Thus, it is significantly important to conduct routine screening for celiac disease in patients with D-IBS.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2013年第1期38-41,共4页
Chinese Journal of Internal Medicine
基金
湖北省卫生厅科研资助项目（JX41）02）
湖北省肠病医学临床研究中心专项基金（2008BCC002）
关键词
乳糜泻
肠易激综合征
患病率
生物学标记
Celiac disease
Irritable bowel syndrome
Prevalence
Biological markers
