四川地区胃食管反流食管外症状的患病现状及危险因素分析

Analysis of Extra-Esophageal Symptoms and its Risk Factors in Gastroesophageal Reflux Patients in Sichuan

目的 探索四川地区胃食管反流食管外症状的患病现状及独立危险因素。方法 选取2019年8月至2020年5月在成都平原、川中地区和川北地区3家三级医院诊断明确的239例胃食管反流病患者,采用反流性疾病问卷(RDQ)、反流症状指数评分量表(RSI)和一般资料问卷进行调查,以RSI>13分作为食管外症状判断标准,用多元Logistic回归分析影响胃食管反流食管外症状发生的独立危险因素。结果 239例胃食管反流患者有131例(54.8%)发生食管外症状,主要表现为心前区疼痛(51.1%)、咽部异物感(47.3%)、声音嘶哑(42.0%)、饭后咳嗽(38.2%)、持续清嗓(26.0%)等。多元Logistic回归分析结果提示,患者BMI、慢性阻塞性肺疾病、焦虑抑郁状态、睡眠障碍、功能性肠病是发生胃食管反流食管外症状的独立危险因素(P<0.01)。结论 四川地区胃食管反流食管外症状患病率较高,临床表现多样,且发生受多种因素影响,医务人员及时有效的干预独立危险因素,可减轻患者的复杂临床症状,提高患者生活质量。

Objective To explore the prevalence and risk factors of extra-esophageal symptoms in gastroesophageal reflux patients in Sichuan Province.Methods A total of 239 cases of patients with gastroesophageal reflux disease who were diagnosed in three tertiary hospitals in Chengdu Plain,Central Sichuan and Northern Sichuan between August 2019 and May 2020.The reflux disease Questionnaire(RDQ),reflux Symptom Index Score Scale(RSI)and general data questionnaire were used for the investigation.The RSI score>13 was used as the criteria for the diagnosis of extresophageal symptoms.Multiple Logistic regression was used to analyze the independent risk factors affecting the occurrence of extra-esophageal symptoms of gastroesophageal reflux.Results A total of 131 cases(54.8%)were found with extra-esophageal symptoms in 239 cases.The main symptoms were pain in the precordial area(51.1%),foreign body sensation in the pharynx(47.3%),hoarseness(42.0%),cough after meals(38.2%),continuous throat clearing(26.0%),etc.Multiple logistic regression analysis indicated that BMI,chronic obstructive pulmonary disease,anxiety,depression,sleep disturbance,and functional bowel disease had significant impact on patients of extra-esophageal symptoms(P<0.01).Conclusion In Sichuan province,the prevalence rate of extra-esophageal gastroesophageal reflux symptoms is high,the clinical manifestations are varied,and the occurrence is affected by multiple factors.Timely and effective intervention of independent risk factors by medical staff can reduce the complex clinical symptoms of patients and improve the quality of life of patients.