胃食管反流病与功能性肠道疾病的重叠及其相关因素

Overlap between gastroesophageal reflux disease and functional bowel diseases:an analysis of related factors

目的:探讨胃食管反流病(gastro-oesophageal reflux disease,GERD)与功能性肠道疾病的重叠情况及其相关因素.方法:2008-07/2008-12我院消化科门诊收治具有反酸、反食、烧心、胸骨后疼痛等症状的患者232例,对其进行反流性疾病问卷调查(reflux disease questionnaire,RDQ),以症状积分(Sc)≥12为症状性胃食管反流标准.将患者分为GERD组(Sc≥12)和对照组(Sc<12)2组,记录患者的身高、体质量、吸烟史、饮酒史.按照罗马Ⅲ诊断标准筛选功能性肠道疾病患者,包括肠易激综合征(irritable bowel syndrome,IBS)、功能性腹泻(functional diarrhea,FD)、功能性便秘(functional constipation,FC)、功能性腹胀(functional bloating,FB)等.采用t检验、χ2检验、Logistic回归分析重叠率及其相关因素.结果:GERD与IBS,FD,FC,FB的重叠率分别为29.1%,15.2%,10.6%,2.0%,均高于对照组(11.1%,3.7%,9.9%,1.2%).GERD组与对照组相比IBS重叠率有显著统计学差异(P<0.05),2组间FD,FC,FB的重叠率无显著统计学差异.GERD症状积分与发生功能性肠道疾病的重叠有相关性(P<0.01),年龄、性别、体质量指数、吸烟史、饮酒史与发生功能性肠道疾病的重叠无相关性.结论:GERD与IBS、FD、FC、FB均有一定的重叠,但与IBS的重叠率最高且明显高于一般人群.GERD患者的症状积分越高,与功能性肠道疾病发生重叠的几率越大.

AIM： To investigate the overlap between gastroesophageal reflux disease （GERD） and functional bowel diseases and analyze the factors related to such overlap. METHODS： A total of 232 consecutive outpatients treated at our hospital from July 2008 to December 2008 due to sour regurgitation, heartburn and retrosternal pain were included in the study. GERD was diagnosed when the score （Sc） of reflux diagnostic questionnaire （RDQ） was greater than or equal to 12. The patients were divided into two groups： GERD patients （Sc≥12） and control ones （Sc 〈 12）. The height, weight, smoking history and drinking history of these patients were recorded. The patients were screened for irritable bowel syndrome （IBS）, functional diarrhea （FD）, functional constipation（FC） and functional bloating （FB） according to Rome III criteria. The overlap between GERD and these disorders as well as the related factors were analyzed by the t-test, chi square test and logistic regression.RESULTS： The prevalences of IBS, FD, FC and FB in GERD patients were higher than those in control patients （29.1% vs 11.1%, 15.2% vs 3.7%, 10.6% vs 9.9% and 2.0% vs 1.2%, respectively）. The prevalence of IBS in GERD patients was significant higher than that in control patients （P 〈 0.005） though no significant differences were observed in prevalences of FD, FC and FB between the two groups. GERD symptom score was significantly related with the overlap between GERD and functional bowel disease （P 〈 0.001）, while body mass index （BMI）, age, sex, smoking history and drinking history had no relation with the overlap. CONCLUSION： IBS, FD, FC and FB in GERD patients are more prevalent than those in the general population, and the prevalence of IBS in GERD patients is significant higher than that in the general population. GERD symptom score has significant relation with the overlap between GERD and functional bowel diseases.