反流性食管炎患者症状与睡眠障碍的研究

Reflux symptoms and sleep disorders in reflux esophagitis patients

目的探讨反流性食管炎患者的症状与睡眠障碍的关系。方法对我院2006年1月～2006年12月经内镜检查确诊为反流性食管炎且排除胃肠道手术史及严重肝、肾、心脑血管病患者共172例，男136例，女36例，平均（56．7±15．8）岁，进行睡眠情况的调查。应用CHISS统计软件对反流性食管炎患者的症状与睡眠障碍的发生及睡眠障碍的表现等资料进行秩和检验、单因素方差分析和逐步回归分析。结果172例反流性食管炎患者合并睡眠障碍者58例，占33．72％。单因素分析提示夜间烧心、夜间反流、夜间或晨起醒来伴有烧心和（或）反流症状，每周夜间烧心反流次数及症状受睡眠体位影响足睡眠障碍的相关因素（P〈0．01）；胸痛与睡眠维持障碍和日间残留效应相关（P〈0．05），咳嗽与睡眠潜伏期长显著相关（P〈0．01）。逐步回归分析提尔夜间反流症状、夜间或晨起醒来伴有烧心和（或）反流症状，以及每周夜间烧心反流次数对睡眠障碍的发生有显著性意义（P〈0．01）。结论反流性食管炎患析的夜间反流症状、频度及醒来即伴随烧心反流症状与睡眠障碍有关。

Objective To investigate the relationship between reflux symptoms and sleep disorders in patients with reflux esophagitis. Methods Endoscopic results, 172 reflux esophagitis patients 136 men and 36 women, mean age （56.7 ± 15.8） years hospitalized from January 2006 to December 2006 were analyzed retrospectively. There was no history of gastrointestinal surgery or severe liver, kidney or cardiocerebrovascular diseases. Questionnaire about sleeping was conducted in all the 172 patients. The relation between reflux symptoms and the onset or manifestation of sleep disorders were analyzed with statistical software CHISS for Rank sum test, one-way anova, stepwise regression analysis. Results About 33.72% （58/172） reflux esophagits patients had sleep disorders. One-way anova analysis indicated heartburn and reflux during night time, awaking at night or morning with heartburn and（or） reflux symptoms, night time heartburn and reflux time and symptoms affected by sleeping postures may be related factors for sleep disorders （P 〈 0.01 ）. Chest pain and sleeping maintenance disability were associated with daytime dysfunction（P 〈0.05）. Coughing was related with the long latent period of sleeping（P 〈 0.01 ）. Stepwise regression analysis indicated that night time reflux, awaking at night or in the morning with heartburn and（or） reflux and weekly night time heartburn, reflux times were significantly related with onset of sleep disorders（P 〈 0.01 ）. Conclusion Night time reflux, frequency, awaking with heartburn and（or） reflux are related with sleep disorders in reflux esophagitis patients.