合并睡眠障碍的反流性食管炎临床特征分析

Clinical characteristics of reflux esophagitis with sleep disorder

目的:探讨合并睡眠障碍的反流性食管炎病人的临床特征。方法:前瞻性调查经内镜检查确诊为反流性食管炎病人共105例的睡眠状况,根据睡眠质量评分将病人分为睡眠障碍组和睡眠正常组。同时应用胃食管反流病问卷评分、汉密尔顿焦虑量表和汉密尔顿抑郁量表对所有病人进行反流症状评分、焦虑抑郁评分及应用洛杉矶分类法对所有病人进行内镜下食管炎分级。结果:合并睡眠障碍的反流性食管炎病人症状评分、汉密尔顿焦虑量表总分及汉密尔顿抑郁量表总分均高于睡眠正常组病人(P<0.05~P<0.01)。C/D级食管炎病人的匹兹堡睡眠质量指数量表评分明显高于A/B级食管炎病人(P<0.01)。反流性食管炎病人的反流症状评分与匹兹堡睡眠质量指数评分呈正相关关系(r=0.482,P<0.01)。结论:合并睡眠障碍的反流性食管炎病人的临床症状更加严重,容易伴随焦虑抑郁,且睡眠质量与食管炎的严重程度相关。

Objective:To investigate the clinical characteristics of reflux esophagitis(RE)patients with sleep disorder.Methods:The sleep status of 105 patients with RE diagnosed by gastroscopy was prospectively investigated.The RE patients were divided into sleep disorder group and normal sleep group according to the Pittsburgh sleep quality index(PSQI)score.The gastroesophageal reflux disease questionnaire(GERDQ),Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD)were used to score the reflux symptoms,anxiety and depression status of all patients,respectively.The Los Angeles classification was used to grade all patients with endoscopic esophagitis.Results:The symptom score,HAMA score and HAMD score of RE patients with sleep disorder were higher than those of RE patients without sleep disorder(P<0.05 to P<0.01).Furthermore,the PSQI score of patients with grade C/D esophagitis was showed to be significantly higher than that of patients with grade A/B esophagitis(P<0.01).Finally,the GERDQ score of patients with RE was found to be positively correlated with PSQI score(r=0.482,P<0.01).Conclusions:The clinical symptoms are more serious in RE patients with sleep disorder.Anxiety and depression are easy to be found,and the severity of esophagitis is showed to be related to sleep quality in this kind of disease.