军人周期性呕吐综合征患病危险因素分析

Risk factors for cyclic vomiting syndrome in servicemen

目的探讨军人周期性呕吐综合征(cyclic vomiting syndrome,CVS)患病危险因素。方法 2012年3-6月对在中部地域服役的解放军陆军某部1 000名现役官兵进行调查。采用功能性胃肠病(functional gastrointestinal disorders,FGIDs)罗马Ⅲ调查问卷进行FGIDs的分类和诊断。心理因素测评应用SCL-90量表,采用Pittsburgh睡眠质量指数量表评价睡眠总体状况。以中文版反流性疾病问卷评分≥12分作为胃食管反流病(gastroesophageal reflux disease,GERD)的诊断标准。应用创伤史筛查问卷调查负性生活事件,记录家庭、学习、工作、个人情感、人际关系和环境适应压力6个方面的压力性事件。结果共纳入合格问卷913份,诊断为CVS 60例为CVS组,无FGIDs官兵491例为对照组。在吸烟史和重叠GERD方面,CVS组多于对照组(P<0.05)。年龄、负性生活事件和压力性事件评分、睡眠质量评分及SCL-90总分CVS组较对照组高(P均<0.05)。多元回归分析提示,SCL-90总分(OR=1.038,P<0.001)、吸烟(吸烟vs从不吸烟,OR=2.785,P=0.026;吸烟vs曾经吸烟,OR=5.102,P=0.047)和年龄(OR=1.131,P=0.008)是军人CVS患病的危险因素(P<0.05)。结论军人CVS的发病可能与精神、心理、吸烟、年龄密切相关。

Objective To investigate the risk factors of cyclic vomiting syndrome （CVS） in serviceman. Methods A questionnaire survey was conducted in 1 000 army servicemen in the middle region of China from March 2012 to June 2012. Functional gastrointestinal disorders （FGIDs） were diagnosed based on the Rome III Modular Questionnaire. All subjects completed symptom checklist 90 （SCL-90） to assess the psychological status and Pittsburgh sleep quality index questionnaire to evaluate the sleep quality. Chinese version of reflux disease questionnaire score ≥ 12 were diagnosed as gastroesophageal reflux disease （GERD）. Negative life events were investigated using trauma history screening questionnaire. The stress events including family, leaming, working, emotional, interpersonal and environmental pressure were recorded. Results Based on 913 eligible questionnaires, 60 servicemen were diagnosed as CVS （CVS group） and 491 as without FGIDs （control group）. More servicemen in CVS group had smoking history and overLapped with GERD when compared with those in control group （P 〈 0.05）. Age, negative life events and stress events scores, sleep quality score and SCL-90 total score in CVS group were statistically higher than those in control group （All P 〈 0.05）. Multiple regression analysis showed SCL-90 total score （OR=1.038, P 〈 0.001）, smoking （OR=2.785, P=0.026, vs never smoking; OR=5.102, P=0.04, vs ever smoking） and age （OR=l.131, P=0.008） were the risk factors for CVS in servicemen （P 〈 0.05）. Conclusion The pathogenesis of CVS in servicemen may be closely correlated with psychiatric and psychological factors as well as smoking and age.