酸和非酸胃食管反流性咳嗽患者的心理状况分析

Psychological status in patients with acid or non-acid gastroesophageal reflux-induced cough

目的比较酸和非酸胃食管反流性咳嗽(gastroesophageal reflux induced cough, GERC)的临床表现和心理状况。方法分析41例单纯酸GERC和31例单纯非酸GERC患者的临床症状与多通道食管内阻抗-pH监测结果,比较酸GERC组、非酸GERC组和健康对照组间一般资料、反流症状积分、焦虑症状评分(generatized anxiety disorder, GAD-7)和抑郁症状评分(patient health questionnaire, PHQ-9)的差异。结果两类GERC患者有相似的咳嗽特点和咳嗽症状积分,酸GERC患者的反酸(χ~2=8.159,P=0.004)、烧心(χ~2=4.108,P=0.043)发生率高于非酸GERC。非酸GERC组患者的焦虑比例最高(45.2%),其次为酸GERC组(41.4%),健康对照组最低(8.0%),3组间比较差异有统计学意义(H=13.015,P=0.000)。非酸GERC组患者的抑郁比例最高(58.1%),其次为酸GERC组(43.9%),健康对照组最低(12.0%),3组间比较有统计学差异(H=17.529,P=0.000)。非酸GERC患者的RSI评分与焦虑症状评分结果间的相关系数为0.675,差异有统计学意义(P=0.000)。结论非酸GERC患者的临床表现与酸GERC相似,伴随的反酸、烧心症状频率较低。两类患者均可能伴有焦虑抑郁症状,非酸GERC患者伴有抑郁症状的发生率较高,针对此类患者制订心身结合的一体化治疗方案对患者康复具有积极的意义。

Objective To compare the clinical manifestations and psychological status in patients with acid and non-acid gastroesophageal reflux-induced cough(GERC).Methods The clinical symptoms,cough symptom score,reflux symptom score and multi-channel intraluminal impedance combined with pH monitoring(MII-pH)results of 41 patients with GERC due to acid reflux and 31 patients with GERC due to non-acid reflux were analyzed.The anxiety symptom score(Generalized Anxiety Disorder,GAD-7)and depression symptom score(Patient Health Questionnaire,PHQ-9)between acid GERC group,non-acid GERC group and normal control group were compared.Results The characteristics of cough and cough symptom scores in patients with two types kinds of GERC were similar.Acid GERC patients were more likely to perceive acid reflux(χ2=8.159,P=0.004)and heartburn(χ2=4.108,P=0.043)compared to non-acid GERC patients.The prevalence rate of anxiety in non-acid GERC patients,adid GERC patients and normal controls were 45.2%,41.4%and 8.0%,respectively(H=13.015,P=0.000).The prevalence rate in non-acid GERC patients,acid GERC patients and normal controls was 58.1%,43.9%and 12.0%,respectively(H=17.529,P=0.000).In non-acid GERC patients,the RSI score was positively correlated with anxiety symptom score(r=0.675,P=0.000).Conclusion The clinical manifestations of non-acid GERC patients are similar to acid GERC patients,with lower frequency of acid reflux and heartburn symptoms.Anxiety and depression symptoms are present in patients with both types of GERC,while non-acid GERC patients are more likely to have depression.A psychosomatic integrated treatment plan would be beneficial to these patients.