|
| WD患者消化道症状临床特征分析 |
| Clinical characteristics of gastrointestinal symptoms in patients with Wilson's Disease |
| 投稿时间：2025-01-23 |
| DOI：10.3969/j.issn.1000-0399.2026.02.005 |
| 中文关键词: Wilson病 消化道症状 神经功能分级 |
| 英文关键词: Wilson's disease Gastrointestinal symptoms Neurological function grading |
| 基金项目:大健康研究院新安医学与中医药现代化研究所专项资金资助(编号:2023CXMMTCM002); 安徽省临床医学研究转化专项(编号:202204295107020047); 2022年度安徽省中医药传承创新科研课题(编号:2022CCZD05) |
|
| 摘要点击次数: 260 |
| 全文下载次数: 45 |
| 中文摘要: |
| 目的 探讨Wilson病（WD）患者的消化道症状的发生及严重程度相关因素，分析症状谱特征。方法 连续纳入2024年10～12月就诊于安徽中医药大学神经病学研究所附属医院的200例WD患者为研究对象，收集一般资料并进行神经功能评估和消化道功能障碍问卷评估，包括口咽、食管胃及肝胆和下消化道35个常见症状，观察消化道症状严重程度，采用多元线性回归（逐步法）及线性回归分析WD消化道症状的影响因素。结果 不同临床分型间高频消化道症状（发生率≥15%）包括排气增多（46.5%）、口干（41.5%）、口臭（37.0%）等，差异有统计学意义（均P<0.05）。不同性别患者消化道症状总分比较，差异无统计学意义（P>0.05）。多元线性回归分析发现，Goldstein ADL分级是消化道症状总分的正相关因素（B=1.789,95%CI:0.529～3.050,P=0.006），分级越高，症状总分越高，病程是消化道症状总分的负相关因素（B=-0.145,95%CI:-0.265～-0.025,P=0.018）。线性回归分析发现，特定症状与Goldstein ADL显著相关：流涎（B=0.241,95%CI:0.125～0.357,P<0.001）、口臭（B=0.161,95%CI:0.030～0.293,P=0.017）和下腹胀（B=0.467,95%CI:0.025～0.905,P=0.037）随分级升高而加重，牙龈出血则呈负相关（B=-0.177,95%CI:-0.326～-0.028,P=0.020）。年龄和病程对症状的影响具有部位特异性：年龄增长与口腔灼烧感（B=7.369,95%CI:2.861～11.877,P=0.002）、牙齿疼痛（B=2.873,95%CI:0.577～5.169,P=0.015）呈正相关，而与食量减少（B=-1.863,95%CI:-3.047～-0.678,P=0.002）、嗳气（B=-2.850,95%CI:-4.537～-1.163,P=0.001）呈负相关；病程延长与口苦或口酸（B=2.063,95%CI:0.422～3.704,P=0.014）、呛咳（B=1.750,95%CI:0.353～3.147,P=0.014）呈正相关。结论 WD患者消化道症状表现多样且其严重程度与Goldstein ADL分级、年龄、病程及临床分型存在显著关联，临床中需针对性开展消化道症状的筛查与干预。 |
| 英文摘要: |
| Objective To investigate the prevalence and severity of gastrointestinal symptoms in patients with Wilson's disease（WD）. Methods A total of 200 WD patients admitted to the Affiliated Hospital of the Institute of Neurology, Anhui University of Chinese Medicine from October 2024 to December 2024 were enrolled. General information was collected and neurological function and gastrointestinal dysfunction questionnaire were performed, including 35 common symptoms of oropharynx, esophagogastric, hepatobiliary and lower gastrointestinal tract. Multiple linear regression（stepwise method） and general linear regression were used to analyze the influencing factors of WD gastrointestinal symptoms. Results χ2 test analysis showed that the frequency of gastrointestinal symptoms（incidence ≥15%） included increased exhaust（46.5%）, dry mouth（41.5%）, halitosis（37.0%）, and so on. Significant differences existed in the distribution of these symptoms among different clinical types（all P<0.05）. Mann-Whitney U test showed no significant difference in the total score of gastrointestinal symptoms between male and female patients. Multiple linear regression analysis showed that Goldstein ADL grade was a positive correlation factor for the total score of gastrointestinal symptoms（B=1.789,95%CI:0.529～3.050,P=0.006）; the higher the grade, the higher the total score of symptoms. The course of disease was negatively correlated with the total score of GI symptoms（B=-0.145,95%CI:-0.265～-0.025,P=0.018）. Linear regression analysis found that specific symptoms were significantly associated with Goldstein ADL: Sialorrhea（B=0.241,95%CI:0.125～0.357,P<0.001）, halitosis（B=0.161,95%CI:0.030～0.293,P=0.017） and lower abdominal distension（B=0.467,95%CI:0.025～0.905,P=0.037） were aggravated with the increase of grade, while gingival bleeding was negatively correlated（B=-0.177,95%CI:-0.326～-0.028,P=0.020）. The effects of age and disease duration on symptoms were site-specific: Increasing age was positively correlated with oral burning sensation（B=7.369,95%CI:2.861～11.877,P=0.002） and dental pain（B=2.873,95%CI:0.577～5.169,P=0.015）, but negatively correlated with food intake reduction（B=-1.863, P=0.002） and belching（B=-2.850,95%CI:-4.537～-1.163,P=0.001）. The prolonged course of disease was positively correlated with bitter or sour mouth（B=2.063,95%CI:0.422～3.704,P=0.014） and choking（B=1.750,95%CI:0.353～3.147,P=0.014）. Conclusions The gastrointestinal symptoms of WD patients are diverse, and their severity is significantly correlated with Goldstein ADL classification, age, course of disease and clinical classification. It is necessary to carry out targeted screening and intervention of gastrointestinal symptoms in clinical practice. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
