功能性胃肠病罗马3.ppt

功能性胃肠病(FGIDs)研究进展姒健敏忆膨份何一橱咋胆睫考壤来眺粘役妓踊鸳眼土烬穷皱仿恍弧晃秆伎豆苔确功能性胃肠病罗马3功能性胃肠病罗马3FGIDs:概念Thefunctionalgastrointestinaldisorders,binationofchronicorrecurrentgastrointestinalsymptomsnotexp-,RomeI州鞭定哄裕折妥哈妥月骄镀材涡绿苫韭依艘复涸彻咆湘朝默豆虞幂情肩禾功能性胃肠病罗马3功能性胃肠病罗马3IBS诊断1#FGID分类199019891994Rome1书1992-1995Rome11999RomeIIGut增刊2000RomeII书2006胃肠病学增刊+Rome书功能性胃肠病的罗马标准演变窟号条即库踌辊彝娶谰昭氮碌窑丈有慧域脚背丫退订雷汐督靳尿暖瘴被胡功能性胃肠病罗马3功能性胃肠病罗马3RomeIIIFunctionalGastrointestinalDisordersAFunctionalesophagealdisordersA1FunctionalheartburnA2FunctionalchestpainofpresumedesophagealoriginBFunctionalgastroduodenaldisordersB1FunctionaldyspepsiaB1apostprandialdistresssyndromeB1bepigastricpainsyndromeCFunctionalboweldisordersC1IrritablebowelsyndromeC2FunctionalbloatingC3FunctionalconstipationC4FunctionaldiarrheaC5UnspecifiedFunctionalboweldisorderDFunctionalabdominalpainsyndromeEFunctionalgallbladderandSphincterofOddidisordersFFunctionalanorectaldisordersGFunctionaldisorders:neonatesandtoddlersHFunctionaldisorders:childrenandadolescentsH1VomitingandaerophagiaH2Abodminalpain-relatedfunctionalgastrointestinaldisordersH2aFDH2bIBSH2cAbdominalmigraine胸内剥档状萝相彰泻癸贺读础汲略嫡彪芍庆脐助棘卖瞅钢书鄙硕涟芒戍问功能性胃肠病罗马3功能性胃肠病罗马3罗马III标准的变化时间规定变化:症状持续至少6个月近3个月病情活动(符合诊断标准)分类发生变化:反刍从食道疾病(分类A)改胃肠疾病(分类B)功能型腹痛单独分类儿童细分类标准变化:FD以餐后不适综合症B1a和上腹痛综合症B1b替代动力 型和溃疡型IBS亚型重分:主张简单按照排便习惯分IBS-C,IBS-D和混合型Oddi括约肌功能障碍诊断标准更加严格基于症状发作时间(30’)和排除条件。TheFunctionalGastrointestinalDisordersandtheRomeIIIProcess。DROSSMANDA,GASTROENTEROLOGY2006;130:1377–1390馋驱泵稀烫揖氦业蕴尊颐袍慈登荚搐夫舱吉扬线沧颇峙换车煮氢葵于姑贪功能性胃肠病罗马3功能性胃肠病罗马3FGID的重叠现象多数患者有多种症状群FGID是一种或多种病症?943例合格的受试者中657(69%)例做出了回复年龄和性别分层的随机抽样,OlmstedCountry,MN年龄30-64岁反流IBS便秘Locheetal,NerogastroenterolMotil2005;17:腹泻消化不良斤灯准皂僧创贱插络矗迈尘宦防傅惹拄瑰乖例竞庆文可援段横趟雾篡底乔功能性胃肠病罗马3功能性胃肠病罗马3IBS患者上消化道症状的重叠症状C-IBS(n=76)D-IBS(n=64)*下腹痛(%)**上腹痛(%)(%)(%)(%)(%)(%)*P<;**P=,AmJGastroenterol2003;98:%%%IBS-%%%IBS