Typical correlation analysis between clinical evaluation of irritable bowel syndrome and direct economic burden indicators during hospitalization
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摘要: 目的 探讨肠易激综合征患者临床评估指标与住院期间直接经济负担指标之间的相关性。方法 回顾广东省中医院2010年1月—2022年12月收治的271例肠易激综合征患者的病历资料，观察临床评估指标(年龄、病程、合并病情况、血清白蛋白计量、血红蛋白计量、入院肠道症状、入院上消化道症状、全身症状等)与住院期间直接经济负担指标(住院时间和住院费用)，对两组资料进行典型相关分析。结果 肠易激综合征患者入院中医证型以脾虚湿盛证为主，老年人证型中虚证较其他年龄层明显增加。典型相关分析结果提示，纳入肠道症状评分后的第1典型相关系数为0.615(P＜0.001)。年龄、病程、合并病种数、肠道症状评分与住院时间、费用均呈正相关(P＜0.05)；血清白蛋白、血红蛋白与住院时间、住院费用呈负相关(P＜0.05)。结论 肠易激综合征患者的临床评估指标与经济负担指标具有一定的相关性。初诊评估肠易激综合征患者需关注患者的基础病及临床症状，还要评估患者的营养状态，从而合理用药并加强营养支持，减少患者住院经济负担。Abstract: Objective To explore the correlation between the clinical evaluation indexes of irritable bowel syndrome(IBS) patients and the economic burden indexes of hospitalization.Methods The medical records of 271 patients with IBS admitted to Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2010 to December 2022 were reviewed, and the clinical evaluation indexes(age, course of disease, comorbidities, serum albumin measurement, hemoglobin measurement, admission intestinal symptoms, admission upper digestive tract symptoms, systemic symptoms, etc.) and the economic burden index of hospitalization(hospitalization time and hospitalization expenses) were observed, and the typical correlation analysis was performed on the two groups of data.Results Patients with IBS admitted to the hospital are mainly characterized by spleen deficiency and dampness stagnation syndrome, and the number of elderly patients with deficiency syndrome is significantly increased compared to other age groups. The results of canonical correlation analysis showed that the first canonical correlation coefficient after the intestinal symptom score was 0.615(P < 0.001). Age, course of disease, number of complicated diseases, score of intestinal symptoms were positively correlated with length of stay and cost(P < 0.05), while serum albumin and hemoglobin were negatively correlated with length of stay and cost of stay(P < 0.05).Conclusion There is a certain correlation between the clinical evaluation index and the economic burden index of patients with IBS. In the initial diagnosis and evaluation of patients with IBS, we should pay attention to the basic disease and clinical symptoms of the patients, and also evaluate the nutritional status of the patients, so as to use drugs reasonably and strengthen nutritional support, and reduce the financial burden of the patients in hospital.
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表 1 不同诊断分型患者临床评估指标及住院期间直接经济负担指标比较
X±S 指标 IBS-C(n=18) IBS-D(n=213) IBS-M(n=19) IBS-U(n=21) t P 年龄/岁 57.00±19.57 50.49±16.83 50.42±12.80 58.14±18.26 4.891 0.180 合并病种数/种 4.22±3.37 5.52±3.57 6.00±3.70 5.71±3.54 3.252 0.354 病程/年 2.77±2.62 4.52±6.44 3.24±2.91 3.99±4.87 0.433 0.933 血清白蛋白/(g/L) 44.36±3.99 43.94±4.61 45.05±4.14 42.38±3.35 3.011 0.389 血红蛋白/(g/L) 123.00±17.91 133.98±16.33 138.85±14.22 135.11±22.77 3.088 0.378 住院天数/d 6.83±2.55 7.12±4.28 7.37±3.53 6.05±2.27 1.181 0.758 住院费用/万 0.79±0.40 0.83±0.44 0.86±0.34 0.78±0.32 0.945 0.815 肠道症状评分/分 1.06±0.73 0.88±0.92 1.47±1.02 0.81±0.68 7.665 0.054 上消化道症状评分/分 0.78±1.22 0.80±1.09 0.79±1.08 0.76±1.26 0.495 0.920 全身症状评分/分 0.44±0.98 0.66±0.82 0.89±1.05 0.48±0.75 4.425 0.219 
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表 2 IBS患者临床评估指标及住院期间直接经济负担指标单因素相关分析
临床评估指标 住院天数(y1) 住院费用(y2) r P r P 年龄/岁 0.32 ＜0.001 0.24 ＜0.001 病程/年 0.14 ＜0.05 0.16 ＜0.01 合并病种数/种 0.30 ＜0.001 0.44 ＜0.001 血清白蛋白/(g/L) -0.23 ＜0.01 -0.21 ＜0.05 血红蛋白/(g/L) -0.17 ＜0.05 -0.16 ＜0.05 肠道症状评分/分 0.29 ＜0.001 0.32 ＜0.001 上消化道症状评分/分 0.20 ＜0.001 0.08 0.19 全身症状评分/分 0.13 ＜0.05 0.08 0.17
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表 3 IBS患者临床指标-经济负担指标典型相关系数及其检验(不含肠道症状评分)
集合 相关性 特征值 威尔克统计 F 分子自由度 分母自由度 P 1 0.434 0.232 0.790 3.328 10.000 266.000 ＜0.001 2 0.164 0.028 0.973 0.925 4.000 134.000 0.451
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表 4 标准化典型相关系数(不含肠道症状评分)
变量 相关系数 临床评估指标变量(x) U1 U2 年龄(x1) -0.424 -0.044 病程(x2) -0.277 0.569 血清白蛋白(x3) -0.159 0.736 血红蛋白(x4) 0.286 0.295 合并病种数(x5) -0.673 0.142 住院经济负担指标变量(y) V1 V2 住院天数(y1) 0.538 -1.366 住院费用(y2) -1.324 0.634
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表 5 IBS患者临床指标-经济负担指标典型相关系数及其检验(含肠道症状评分)
集合 相关性 特征值 威尔克统计 F 分子自由度 分母自由度 P 1 0.615 0.609 0.603 6.474 12.000 270.000 ＜0.001 2 0.172 0.030 0.970 0.829 5.000 136.000 0.531
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表 6 标准化典型相关系数(含肠道症状评分)
变量 相关系数 临床评估指标变量(x) U1 U2 年龄(x1) -0.197 0.059 病程(x2) -0.176 0.654 血清白蛋白(x3) -0.165 0.551 血红蛋白(x4) 0.263 0.235 合并病种数(x5) -0.454 0.335 肠道症状评分(x6) -0.739 -0.281 住院经济负担指标变量(y) V1 V2 住院天数(y1) 0.318 -1.434 住院费用(y2) -1.209 0.833
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