胃食管反流病相关危险因素及诊疗特点分析

Analysis of the risk factors of gastrointesital esophageal reflux disease and its clinical features

目的探讨胃食管反流病(GERD)发病的危险因素及诊疗特点。方法利用2004年3月至5月在北京大学人民医院消化内科门诊就诊患者填写的反流性疾病问卷(RDQ)表及其他相关信息进行分析,并在2011年5月对部分调查者进行电话回访。结果 1052例患者填写RDQ表,可利用资料为1045例(占99.3%)。GERD在消化门诊就诊患者中占16.3%;其发病无季节规律,平均病程6.45年。老年(OR=1.02,95%CI:1.01～1.04)、体力劳动(OR=1.79,95%CI:1.13～2.86)及经常饮酒(OR=2.63,95%CI:1.17～5.92)增加GERD危险性。而性别、吸烟、体重指数(BMI)及ABO血型与GERD发病无相关性。GERD患者中29.6%合并咽部及呼吸系统症状,相比非GERD组为高(χ2=37.6,P<0.01);26.3%的GERD患者服用抗酸药物治疗,其中9.3%患者服用质子泵抑制剂治疗;40%的患者对治疗效果不满意。7年后对307例调查者回访,以往存在GERD者中44.0%病例症状仍明显。结论 GERD为综合医院消化科就诊患者的常见病症。老年、体力劳动及经常饮酒是GERD的高危因素。GERD合并食管外表现多见,症状不易控制。半数患者症状持续多年。

Objective To explore the risk factors of gastrointestinal esophageal reflux disease （GERD） and its clinical characteristics. Methods We analyzed the Reflux Disease Questionnaire （RDQ） and other related data from GI out-patient department, People＇s hospital, Peking University during March 2004 to May 2004, with follow-up call made in May of 2011. Results 1045 （ 99. 3% ） out of 1052 RDQ questionnaires were available. GERD ,noted in 16. 3% patients ,was not seasonal. The mean course of disease took for 6. 45 years. Old age [ odds ratio （OR） = 1.02 ;95 % confidence interval （CI） = 1. O1 - 1.04 ], physical work （ OR = 1.79,95 % CI ： 1.13 2. 86） and drinking （ OR = 2. 63,95% CI ： 1.17 - 5. 92） increased the risk of GERD. Gender, smoking, body mass index,as well as blood type were not associated with GERD. Among GERD cases,29. 6% had pharyngeal and respiratory symptoms, significantly higher than non-GERD cases （ x^2 =37.6,P 〈 0. 01 ）. 26. 3% GERD cases took antacid drugs ,9. 3% of which took proton pump inhibitors, and 40% cases were not satisfied with the treatment. 7 years later,307 cases received follow-up 7 years later. 44. 0% of the GERD cases：still suffered from signif- icant symptoms. Conclusion GERD is common in GI department of comprehensive hospitals. Olde age, physical work and excessive drinking are risk factors of GERD. Symptoms of GERD are hard to icontrol and mostly combining with extra-esophageal manifestations, and would last for years in half of the cases.