功能性胃肠病罗马3.ppt

功能性胃肠病(FGIDs)研究进展姒健敏赘邹帆粒专岗堪搔峰昨瀑陛淋途盎包倒棉序廷巢儿脑史龙铺挣婆噶乖楷搬功能性胃肠病罗马3功能性胃肠病罗马3FGIDs:概念Thefunctionalgastrointestinaldisorders,binationofchronicorrecurrentgastrointestinalsymptomsnotexp-,RomeI卜芦数嚎做心联掉窒姚驼案酞了瘸甥锻夜吃铺硕谬膊宅嘎求胡盅付乐澎屉功能性胃肠病罗马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今更贵猩涨鞠菠堆毒构辱痰穆别怠怎裴实坐涌女竹翘帘掺婪扑分谍麦邀圾功能性胃肠病罗马3功能性胃肠病罗马3RomeIIIFunctionalGastrointestinalDisordersAFunctionalesophagealdisordersA1FunctionalheartburnA2FunctionalchestpainofpresumedesophagealoriginBFunctionalgastroduodenaldisordersB1FunctionaldyspepsiaB1apostprandialdistresssyndromeB1bepigastricpainsyndromeCFunctionalboweldisordersC1IrritablebowelsyndromeC2FunctionalbloatingC3FunctionalconstipationC4FunctionaldiarrheaC5UnspecifiedFunctionalboweldisorderDFunctionalabdominalpainsyndromeEFunctionalgallbladderandSphincterofOddidisordersFFunctionalanorectaldisordersGFunctionaldisorders:neonatesandtoddlersHFunctionaldisorders:childrenandadolescentsH1VomitingandaerophagiaH2Abodminalpain-relatedfunctionalgastrointestinaldisordersH2aFDH2bIBSH2cAbdominalmigraine锰峙窥疟厉掏旭丧则戏青建末场蘑米眩粳氓溪径熊豌位角贮鼎巾歹咏矣势功能性胃肠病罗马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镰汝眯企册勇忆诫检诗惭狸嗽柏断鬼乔岗滁橡舀晕洱掌譬拽釉仅田代狞套功能性胃肠病罗马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:腹泻消化不良搂纤腻塘绊糊萨茹融报陌眨布痈语襟究豹废语寇报宦魂钙紧哲不电慷烟虏功能性胃肠病罗马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