北京城市社区老年胃食管反流病临床特征研究

Study on clinical characteristics of elderly patients with gastroesophageal reflux disease in Beijing urban communities

目的探讨北京城市社区老年胃食管反流病(GERD)的临床特征,为临床诊断及治疗提供帮助。方法根据蒙特利尔标准、中国GERD共识意见等,选取2013年6月~2016年12月在北京城区4家医院就诊的398例GERD患者作为研究对象,按照年龄将其分为老年组(≥60岁,n=126)与中青年组(<60岁,n=272)。通过问卷调查,分析两组患者治疗前的临床症状特征、生活质量,并比较两组患者的治疗有效率。结果老年组患者的反酸、烧心发生率均低于中青年组,食管外症状发生率高于中青年组,差异有统计学意义(P<0.05);两组患者的胸痛发生率比较,差异无统计学意义(P>0.05)。老年组患者的生理功能(PF)评分高于中青年组,差异有统计学意义(P<0.05);两组患者其他生活质量各维度评分比较,差异无统计学意义(P>0.05)。经过8周药物的治疗,老年组患者的治疗有效率为57.14%(72/126),低于中青年组的82.35%(224/272),差异有统计学意义(P<0.05)。结论老年人GERD典型症状不明显,且治疗后缓解率低,但老年患者的生活质量与中青年无明显差异。

Objective To study the clinical characteristics of elderly patients with gastroesophageal reflux disease (GERD) in Beijing urban communities,so as to provide help for clinical diagnosis and treatment.Methods According to the Montreal standard and the Chinese GERD consensus opinion,a total of 398 patients with GERD who were admitted to four hospitals in Beijing urban areas from June 2013 to December 2016 were selected as subjects,and they were divided into the elderly group (≥60 years old,n=126) and the young and middle-aged group (<60 years old,n=272) according to their age.Through the questionnaire survey,the clinical symptoms and quality of life of the two groups were analyzed before treatment,and the effective rate of the two groups was compared.Results The incidence rates of acid reflux and heartburn in the elderly group were lower than those in the young and middle-aged group,the incidence rate of extra-esophageal symptoms was higher than that in the young and middle-aged group,and the differences were statistically significant (P<0.05).There was no significant difference in the incidence rate of chest pain between the two groups (P>0.05).The physiological function (PF) score in the elderly group was higher than that in the young and middle-aged group,and the difference was statistically significant (P<0.05).There were no significant differences in the scores of other quality of life between the two groups (P>0.05).After 8 weeks of treatment,the effective rate in the elderly group was 57.14%(72/126),which was lower than that in the young and middle-aged group accounting for 82.35%(224/272),and the difference was statistically significant (P<0.05).Conclusion The typical symptoms of GERD in the elderly are not obvious,and the remission rate after treatment is low,but the quality of life of elderly patients is not significantly different from that of young and middle-aged patients.