北京上海胃食管反流症状的流行病学调查

An epidemiologic study on symptomatic GER in Beijing and Shanghai

目的了解北京、上海成人胃食管反流病（ＧＥＲＤ）和反流性食管炎（ＲＥ），在１９９６年７～９月调查时一年内的患病率及其相关性疾病和危险因素等。方法对两市１８～７０岁城乡常住人口５０００例，进行整群、分层、随机抽样的问卷调查。以反酸、烧心、反食症状程度和频度的积分（Ｓｃ，最高１８分）作为反流的指标，Ｓｃ≥６表明存在症状性反流（ＧＥＲ）；再抽取一部分反流阳性病人和对照者用胃镜和２４小时ｐＨ监测作精查，根据精查的正确率对普查结果校正后测算出患病率。结果（１）共４９９２例完成了筛查，人群中每日有烧心者占２．５％；Ｓｃ≥６者４４８例占８．９７％，男女之比为１∶１．１；精查正确率为６４％，据此推测ＧＥＲＤ的患病率为５．７７％，ＲＥ为１．９２％。（２）分层分析显示，有反流症状者北京（１０．１９％）多于上海（７．７６％），北京的男性病人、体力劳动者及农村的患病率均高于上海；此外，４０岁以上的患病率增多。（３）反流组伴发口咽喉病患、哮喘和支气管炎的频率比非病人人群明显为高。结论调查结果显示，ＧＥＲＤ为多发病，但我国南北方的患病率有差别。ＧＥＲＤ和ＲＥ的比值为３∶１。年龄（ＯＲ１．０１）、饱食（ＯＲ１．９９）、油腻食物（ＯＲ６．５?

Objective To explore the one yearpoint prevalences (JulSep,1996) of symptomatic gastroesophageal reflux (GER), gastroesophageal reflux disease (GERD) and reflux esophagitis (RE) among adult population in Beijing and Shanghai and to identify the risk factors of GERD. Methods 5 000 residences of the two cities, age between 1870 were studied through questionaire. Study was done by clustering sampling from city, surburban and rural areas using simple random sampling. Symptom scores (Sc) of the intensity and frequency of heartburn, acid reflux and regurgitation within one year at the time of study were taken as indices of acid reflux (highest Sc=18) and Sc6 indicated the presence of symptomatic GER. A case control study was also performed in some subjects from the survey to confirm the diagnosis of GERD and RE using gastroscopy and 24h pH monitoring. An estimation of the prevalence of GERD and RE was made on the basis of correct diagnostic rates of the diseases. Results (1) 4 992 subjects completed the survey, 2.5% of the people had heartburn once a day, 448 people accounted for 8.97% of the population screened had symptomatic GER (Sc6), and male to female ratio was 11. 1. Estimated prevalences for GERD and RE were 5.77% and 1.92% respectively. (2) Stratified analysis indicated that the prevalence of symptomatic GER in Beijing (10.19%) was higher than that in Shanghai (7.76%), and there was also a higher prevalence of GER in male, in laboring people and in people of rural areas in Beijing as compared with Shanghai. (3) Logistic analysis indicated that GER had a close relatioship with dental, pharnyngolaryngeal disorders and respiratory diseases, such as asthma and bronchitis, etc. Conclusions GERD is different in the northern and southern area of China. Ratio between GERD and RE is 31 in our study. Age>40 (OR 1.01), greasy food (OR 6.56), big appetite (OR 1.99), tiredness (OR 2.35), emotional stress (OR 2.22), pregnancy (OR 6.80) and constipation (OR 1.65) are the risk factors of GERD.