社区人群中胃食管反流病的危险因素及其对生活质量的影响

The risk factors and impact of gastroesophageal reflux disease on quality of life in general population

目的探讨社区人群中胃食管反流病(GERD)的危险因素及其对生活质量的影响。方法2003年5-9月,采用整群和分层抽样的方法,在广东省内随机选取了广州市(较发达城市)、惠州市(中等发达城市)和惠阳县新圩镇(农村地区)作为调查地区,采用最近衍生出的中文版反流性疾病问卷(RDQ)进行调查。对调查中收集到的GERD症状人群进行危险因素和生活质量的分析。在调查中,每发现1例GERD患者,随后即选取2例健康人作为对照以比较和分析生活质量,生活质量的评估采用SF-36量表。用SPSS10.0作卡方检验、t检验和logistic回归分析等。结果调查中共收集到的GERD症状人群(RDQ评分≥12)83例,并选取166例健康人作为对照。男性患病率高于女性,分别为2.6%和2.4%,但两者差异无统计学意义;65岁以上是相对高发人群(3.5%),但各年龄组GERD的患病率差异亦无统计学意义;体重指数与GERD并无明显的相关性。离婚、分居或丧偶人群(OR4.61)及工作压力大者(OR3.43)倾向于发生GERD。与健康对照组相比,GERD患者的生活质量明显下降。结论心理社会因素在GERD发病中可能起一定的作用,其对患者的生活质量有负面影响。

Objectives To assess the risk factors of gastroesophageal reflux disease （GERD） in the general population and its impact on health-related quality of life （HRQOL）. Methods A face-to-face interview was carried out in Guangdong Province using a validated Chinese version Reflux Disease Questionnaire （RDQ） to assess the prevalence of GERD. Random clustered sampling of permanent inhabitants aged 18 to 90 years was carried out under stratification of urban and suburban areas. The impact of GERD on HRQOL was evaluated using the Chinese version of SF-36. The statistical analysis was performed with SPSS 10. 0 programs. Results A total of 83 GERD patients were collected and 166 healthy subjects were selected as control. There was no difference in prevalence between male （2. 6% ） and female （2. 4% ）. There was no significant association between age and prevalence of GERD symptoms. Divorced/ widowed/separated subjects （ OR 4.61 ） and subjects with severe working burden （ OR 3.43 ） were significantly more likely to report GERD symptoms. As compared with the general population, subjects with GERD symptoms experienced considerable impairment in quality of life. Conclusions Psychosoeial factors may play important roles in the production of GERD symptoms. GERD has a negative impact on HRQOL.