西安地区老年胃食管反流病发病情况调查

An investigation for gastroesophageal reflux disease morbidity of aged patients in Xi'an

目的了解西安地区老年人胃食管反流病(GERD)的发病情况,同时评价GerdQ量表对GERD的诊断价值。方法随机选取消化内科门诊老年患者894例,非老年患者1 010例,应用标准方法诊断GERD,比较老年与非老年GERD的症状、发生率及食管酸暴程度;所有GERD患者均进行GerdQ评分。结果 (1)老年患者GERD检出率高于非老年患者(P<0.025);(2)老年糜烂性食管炎(EE)中男性检出率高于女性及非老年男性(P<0.05),老年非糜烂性反流病(NERD)中女性检出率高于男性及非老年女性(P<0.025);老年患者DeMeester评分高于非老年患者(P<0.001);(3)应用GerdQ量表与标准方法比较,GERD检出率差异无显著性,老年GERD患者的GerdQ评分低于非老年患者(P<0.001)。结论 GERD发生率随年龄增长而增高;老年GERD患者的非典型症状及食管外症状较突出、食管黏膜损害较非老年患者加重;GerdQ量表对GERD的初步诊断具有临床应用价值。

Objective To investigate gastroesophageal reflux disease（GERD） morbidity of aged patients in Xi＇an,and evaluate the diagnostic value of gastroesophageal reflux disease questionnaire（GerdQ） in GERD.Methods 894 aged patients and 1 010 non-aged patients from digestive disease department of our hospital outpatient service were included randomly,each patient accepted the following three inspecting methods： endoscopy,24 hour esophagael pH monitoring,and proton pump inhibitor（PPI） test.All patients accepted GerdQ survey.GERD-related symptoms,morbidity and esophageal acid exposure of aged GERD patients and non-aged GERD patients were analyzed.Results（1） GERD morbidity of aged patients was higher than that of non-aged patients（P0.025）;（2） Erosive esophagitis（EE） detection rate of aged male patients was higher than that of aged female patients（P0.05） and non-aged male patients,non-erosive reflux disease（NERD） detection rate of aged female patients was higher than that of aged male patients and non-aged female patients（P0.025）,DeMeester score of aged patients was higher than that of non-aged patients（P0.001）;（3） Differences of GERD morbidity between GerdQ diagnosing and standard inspecting methods was not significant,GerdQ score of aged patients was lower than that of non-aged patients（P0.001）.Conclusion GERD morbidity raises up along with aging;atypical symptoms and extra-esophageal symptoms are prominent in aged GERD patients,esophageal mucosa injury of aged GERD patients is much severer than that of non-aged GERD patients;GerdQ is a convenient and practical mean for GERD diagnosis.