胃食管反流病与颈椎病相关性研究

Correlation between gastroesophageal reflux disease and cervical spondylosis

目的探讨颈椎病患者是否为胃食管反流病(gastroesophageal reflux disease,GERD)的高发人群。方法 321例经临床及磁共振诊断为颈椎病的患者作为颈椎病组,同期选取249名健康体检者作为对照组,进行RDQ评分问卷调查,比较颈椎病组及对照组的RDQ评分及GERD发生率差异是否有统计学意义,颈痛程度与RDQ评分是否相关,并对可能危险因素及颈椎病分型情况进行统计学分析。结果颈椎病组RDQ评分明显高于对照组(P<0.05);以RDQ评分≥12分作为GERD评判标准,颈椎病组GERD 43例(13.4%),对照组GERD 17例(6.8%),颈椎病组GERD发生率明显高于对照组(P<0.05);不同颈痛程度组间RDQ评分差异有统计学意义(P<0.05);各型颈椎病中,交感神经型发生GERD的风险明显高于其他各型(P<0.05);颈椎病合并GERD的危险因素主要为女性、非甾体抗炎药和精神心理因素。结论颈椎病患者发生GERD的风险较高,且以交感神经型最为显著。女性、药物和精神心理因素是颈椎病合并GERD的主要危险因素。

Objective To investigate whether patients with cervical spondylosis are high-risk group of gastroesophageal reflux disease （GERD）.Methods Three hundred and twenty-one cases of cervical spondylosis diagnosed by clinical symptoms and MRI were included as cervical spondylosis group.At the same time,249 healthy volunteers were included as control group.The RDQ questionnaire was completed in order to find out whether the RDQ score and GERD incidence had significant difference between two groups,and the correlation between neck pain degree and RDQ score was investigated.Possible risk factors and cervical spondylosis types were also considered in statistical analysis.Results RDQ score was obviously higher in cervical spondylosis group than that in control group （P ＜ 0.05）.Those with RDQ ≥12 were considered to get GERD,and the GERD patients were 43 cases （13.4％） in cervical spondylosis group and 17 cases （6.8％） in control group.The GERD incidence of cervical spondylosis group was obviously higher than that of control group （P ＜ 0.05）.Patients with different degrees of neck pain had different RDQ scores （P ＜ 0.05）.In all types of cervical spondylosis,sympathetic nerve type were significantly higher risks of GERD （P ＜ 0.05）.Female,non-steroidal anti-inflammatory drugs and psychological factors were considered to be risk factors of cervical spondylosis with GERD.Conclusion Patients with cervical spondylosis have a higher risk of GERD,especially for sympathetic nervetype.Female,drug and psychological factors are major risk factors of cervical spondylosis with GERD.