焦虑抑郁及生活事件对非糜烂性胃食管反流病的影响

Effects of anxiety, depression and life events on non-erosive gastroesophageal reflux disease

目的 探讨焦虑抑郁及生活事件对非糜烂性胃食管反流病（N ERD）患者的影响.方法选取2016年11月至2017年12月就诊于石河子大学医学院第一附属医院的135例NERD患者（NERD组）和同期的133名健康体检志愿者（健康对照组）.采用调查问卷的方式对纳入对象进行焦虑自评量表（SAS）、抑郁自评量表（SDS）、生活事件量表（LES）和胃食管反流病问卷（GerdQ）评分.统计学方法采用Mann-Whitney秩和检验、卡方检验和Spearman秩相关检验.结果NERD组中焦虑患者占46.67％（63/135）,高于健康对照组的1.50％（2/133）,差异有统计学意义（χ2=74.38,P〈0.01）;NERD组中抑郁患者占12.59％（17/135）,高于健康对照组的0（0/133）,差异有统计学意义（χ2=17.88,P〈0.01）.NERD组SAS评分为48分（45分,52分）,高于健康对照组的37分（33分,43分）,差异有统计学意义（Z=-11.03,P〈0.01）;NERD组SDS评分为46分（41分,50分）,高于健康对照组的36分（32分,40分）,差异有统计学意义（Z=-11.03,P〈0.01）.NERD组LES评分为32分（10分,45分）,高于健康对照组的3分（0分,32分）,差异有统计学意义（Z=-2.18,P=0.03）;NERD组LES负性事件评分为21分（3分,36分）,高于健康对照组的0分（0分,23分）,差异有统计学意义（Z=-2.19,P=0.03）.GerdQ评分与SAS、SDS、LES评分和LES负性事件评分均呈正相关,差异均有统计学意义（r=0.65、0.60、0.29、0.29,P均〈0.05）.结论焦虑抑郁、生活事件是NERD的影响因素.随着焦虑抑郁程度和生活事件（尤其是负性生活事件）影响程度的加深,NERD症状加重.

Objective To investigate the effects of anxiety ,depression and life events on patients with non-erosive gastroesophageal reflux disease （NERD） .Methods From November 2016 to December 2017 ,at The First Affiliated Hospital of the Medical College ,Shihezi University ,135 patients with NERD （NERD group） and 133 volunteers who received physical examination at the same period were enrolled （healthy control group） .The scores of self-rating anxiety scale （SAS） ,self-rating depression scale （SDS ） ,life event scale （LES ） and gastroesophageal reflux disease questionnaire （GerdQ ） of the enrolled individuals were obtained by questionnaire .Mann-Whitney ranking test ,chi square test and Spearman rank correlation test were performed for statistical analysis .Results The patients with anxiety in NERD group accounted for 46 .67% （63/135） ,which was higher than that in healthy control group （1 .50% ,2/133） ,and the difference was statistically significant （χ2 =74 .38 , P〈 0 .01） .The patients with depression in NERD group accounted for 12 .59% （17/135） ,which was higher than that of healthy control group （0 ,0/133） ,and the difference was statistically significant （χ2 = 17 .88 ,P〈 0 .01） .The SAS score of NERD group was 48 points （45 points ,52 points） ,which was higher than that of healthy control group （37 points （33 points ,43 points）） ,and the difference was statistically significant （Z=-11 .03 ,P〈0 .01） .The SDS score of NERD group was 46 points （41 points ,50 points） ,which was higher than that of healthy control group （36 points ,32 points to 40 points） ,and the difference was statistically significant （Z= -11 .03 , P〈0 .01） .The LES score of NERD group was 32 points （10 points ,45 points） , which was higher than that of healthy control group （3 points ,0 points to 32 points） ,and the difference was statistically significant （Z= -2 .18 ,P=0 .03） .The score of LES negative events in NERD group was 21 points （3 points ,36 points） ,which was higher than that of the healthy control group （0 points ,0 points to 23 points） , and the difference was statistically significant （Z= -2 .19 , P=0 .03） .GerdQ score was positively correlated with SAS ,SDS ,LES scores and LES negative event score ,and the differences were all statistically significant （r=0 .65 ,0 .60 ,0 .29 and 0 .29 ,all P〈 0 .05） .Conclusions Anxiety ,depression and life events are the influencing factors of NERD .The greater the impact of anxiety ,depression and life event （especially negative live events） ,the more severe the NERD symptoms .