长航官兵胃食管反流病发病情况、危险因素及干预效果研究

Morbidity, risk factors, and intervention of gastroesophageal reflux disease in long-term sailors of navy

目的研究长航官兵胃食管反流病（GERD）的发病情况及相关危险因素，观察相应干预措施的效果。方法456名长航官兵（男342例，女84例），于长航开始、8周后及16周分别进行3次问卷调查。长航8周后观察GERD的发病率变化，并采用Logistic回归进行危险因素分析。针对相应危险因素对长航官兵进行干预，时间为8周。8周后再次观察发病率的变化。结果收回3份有效问卷的人数422人（男319人，女73人）。长航8周后GERD发病率为27．5％，显著高于长航开始时（19．2％，P〈0．01,χ2=8．11）。单因素Logistic回归分析发现精神压力大、工作强度高、吸烟、晕船、肥胖、过饱饮食与GERD关系密切（均P〈0．05）。针对这些因素干预8周后GERD发病率为21．5％，显著低于长航8周时（0．01〈P〈0．05，χ2=4．34）。结论长航8周后GERD发病率显著增加。精神压力大、工作强度高、吸烟、晕船、肥胖、过饱饮食为胃食管反流病的危险因素。干预后GERD发病率降低。

Objective To investigate the morbidity, risk factors, and effects of intervention of gastroesophageal reflux disease （GERD） in long-term sailors of navy. Methods 456 long-term sailors of navy, 342 males and 84 females, underwent questionnaire survey thrice： at the beginning of long-term navigation, and 8 and 16 weeks after the long-term voyage. Logistic regression was used to analyze the morbidity, risk factors, and effects of intervention. Results 422 subjects, 319 males and 73 females completed 3 effective questionnaires. The morbidity of GERD 8 weeks after the long-term voyage was 27.5% , significantly higher than that at the beginning （19.2%, P 〈0.01, χ2=8.11）. Logistic regression showed that mental stress, work intensity, smoking, seasickness, obesity, and overeating were all positively correlated with GERD （all P 〈0,05）. The morbidity of GERD 16 weeks later, after intervention targetting the above-mentioined risk factors for 8 weeks, was 21.5%, significantly lower than that 8 weeks after the voyage （0.01 〈 P 〈 0.05, χ2=4.34）. Conclusion The morbidity of GERD increases after long-term voyage. Mental stress, work intensity, smoking, seasickness, obesity, and overeating are relevant risk factors. Intervention works to decrease the morbidity.