不同亚型胃食管反流病睡眠障碍状况及治疗对睡眠障碍的影响

Sleep disorders in different subtypes of gastroesophageal reflux disease and the effect of treatment on sleep disorders

目的观察不同亚型胃食管反流病(GERD)睡眠障碍的发生情况。方法选取2019年1月~2020年8月于解放军联勤保障部队第九〇〇医院就诊并完成胃镜检查的GERD患者,按照不同亚型分为非糜烂性反流病(NERD)组53例、糜烂性反流病(RE)组68例。记录患者一般资料,于治疗前和规范治疗12周后完成胃食管反流病问卷(GERDQ)和匹兹堡睡眠质量指数问卷(PSQI)和柏林问卷。比较NERD组、RE组的GERD问卷得分、PSQI问卷得分、OSAHS发病率,分析GERD问卷与PSQI问卷得分的相关性。结果NERD组、RE组性别、年龄、体质量指数(BMI)、高血压患病率等一般资料比较,差异无统计学意义(P>0.05)。RE组饮酒率33.82%,高于NERD组的16.98%,组间差异有统计学意义(P<0.05)。治疗后NERD组和RE组的GERDQ、PSQI的平均积分均较治疗前降低,治疗前后差异有统计学意义(P<0.05)。RE组的GERDQ、PSQI略高于NERD组,但两组间差异无统计学意义(P>0.05)。患者的GERDQ和PSQI积分呈正相关,相关系数r=0.504,P=0.037。治疗前两组间的OSAHS发生率比较,差异无统计学意义(P>0.05)。治疗后两组发生率均有下降,但与治疗前比较OSAHS发生率差异无统计学意义(P>0.05)。结论GERD患者的不同类型不影响睡眠障碍及OSAHS的发生率,但GERD症状的严重程度可对睡眠障碍程度产生影响,控制GERD病情可改善睡眠障碍状况。

Objective To observe the incidence of sleep disorders in different subtypes of gastroesophageal reflux disease(GERD).Methods According to the inclusion and exclusion criteria,GERD patients who had completed gastroscopy in our department from January 2019 to August 2020 were selected and divided into non erosive reflux disease(NERD)group(53 cases)and erosive reflux disease(RE)group(68 cases)according to different subtypes.The general data of the patients were recorded,and the gastroesophageal reflux disease questionnaire(GERDQ),Pittsburgh sleep quality index(PSQI)and Berlin questionnaire were completed before treatment and 12 weeks after standard treatment.The scores of GERD,PSQI and incidence rate of OSAHS in group NERD and group RE were compared,and the correlation between GERD questionnaire and PSQI score was analyzed.Results There was no significant difference in gender,age,BMI and hypertension prevalence between BERD group and RE group.The drinking rate of Re Group was 33.82%,which was higher than that of NERD group(16.98%).The difference was statistically significant(P<0.05).After treatment,the average scores of GERDQ and PSQI in NERD group and RE group were lower than those before treatment,and the differences were statistically significant(P<0.05).GERDQ and PSQI of RE group were slightly higher than NERD group,but there was no significant difference between the two groups(P>0.05).There was a positive correlation between GERDQ and PSQI score(r=0.504,P=0.037).There was no significant difference in the incidence of OSAHS between the two groups before and after treatment.After treatment,the incidence of OSAHS in both groups decreased,but there was no significant difference in the incidence of OSAHS before and after treatment.Conclusion Different types of GERD patients do not affect the incidence of sleep disorders and OSAHS.The severity of symptoms can affect sleep disorders.Controlling GERD can improve sleep disorders.