难治性反流性食管炎的相关危险因素分析

Analysis the related risk factors of refractory reflux esophagitis

目的探讨难治性反流性食管炎（RRE）发病的相关危险因素。方法收集2012年3月-2015年3月我院收治的经胃镜检查诊断的反流性食管炎（RE）患者的临床资料,按质子泵抑制剂治疗8周后症状缓解情况分为RRE和非难治性反流性食管炎（NRRE）,采用调查问卷对患者的一般情况、临床症状、内镜检查等资料进行回顾分析。结果年龄、病程、BMI值、饮酒史、洛杉矶分类、服用药物、膈疝、遗传因素、临床症状、长期焦虑、抑郁状态及睡眠障碍是RRE发病的危险因素,两组比较差异有统计学意义（P〈0.05）,Logistic回归分析显示,膈疝、肥胖、临床症状及焦虑抑郁严重是RRE的独立危险因素。结论 RRE的发生与多种因素相关,膈疝、肥胖、临床症状及焦虑抑郁严重患者更易患RRE。

Objective To explore the related risk factors of pathogenesisof refractory reflux esophagitis（RRE）. Methods Clinical data of patients who were diagnosed as reflux esophagitis（RE）from March 2012 to March 2015 of our hospital were selected.Clinical data of patients were divided into RRE group and non-refractoryreflux esophagitis group（NRRE）group according to the symptoms remission situation after PPIs treatment for 8 weeks.Data liked general situation,clinical symptoms,endoscopic examination of patients were analyzed retrospectively by using questionnaire. Results Age,course of diseases,BMI,history of alcohol intake,taking the anticholinergic drugs,family heredity history,clinical symptoms,diaphragmatic hernia,chronic anxiety,depression and sleep disturbance were RRE risk factors of patients between two group,and the difference had statistical significance（P〈0.05）.Logistic regression analysis revealed that diaphragmatic hernia,obesity,clinical symptoms and serious anxiety-depression were RRE independent risk factors. Conclusion The incidence of RRE is related to many factors,and patients with diaphragmatic hernia,obesity,clinical symptoms and serious anxiety-depression are more susceptible to RRE.