胃食管反流病患者食管动力异常与精神心理因素的相关性研究

Correlation Between Abnormal Esophageal Motility and Psychosocial Factors in Patients With Gastroesophageal Reflux Disease

背景:胃食管反流病(GERD)是消化系统常见病之一,其发病机制尚不明确。GERD患者常伴有焦虑抑郁和无效食管动力,焦虑抑郁与食管动力相关性的研究较少。目的:探究不同亚型GERD患者的精神心理状态,并分析其与食管动力的相关性。方法:纳入2018年9月—2022年6月晋城市人民医院诊断的96例具有典型反酸、烧心症状且GerdQ≥10分的GERD患者,根据胃镜下表现分为非糜烂性反流病(NERD)组(77例)和反流性食管炎(RE)组(19例),比较两组的一般资料、临床症状、焦虑抑郁评分以及食管高分辨率测压结果。结果:NERD组与RE组的性别差异有统计学意义(P<0.05)。NERD组焦虑自评量表(SAS)评分为44.00(29.00,58.00),RE组为23.00(20.00,29.38),NERD组明显高于RE组,差异有统计学意义(P<0.01)。两组抑郁自评量表(SDS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分差异无统计学意义(P>0.05)。GERD患者远端收缩积分(DCI)与SAS评分之间存在显著负相关性(P<0.05),DCI与SDS、HAMA、HAMD评分之间无相关性(P>0.05)。结论:NERD患者的焦虑状态较RE患者更明显,GERD患者焦虑状态与DCI呈负相关,焦虑状态可能通过影响食管动力参与GERD发病。

Background:Gastroesophageal reflux disease(GERD)is a common digestive system disorder,but its underlying causes are still unclear.Patients with GERD often experience anxiety,depression,and ineffective esophageal motility.However,there have been limited studies on the relationship between anxiety/depression and esophageal motility.Aims:To investigate the psychosocial status of patients with different subtypes of GERD and analyze its correlation with esophageal motility.Methods:A total of 96 GERD patients presenting typical acid reflux and heartburn symptoms with GerdQ score≥10 from September 2018 to June 2022 at Jincheng People's Hospital were enrolled.Patients were divided into non⁃erosive reflux disease(NERD)group(77 cases)and reflux esophagitis(RE)group(19 cases)based on gastroscopy findings.General data,clinical symptoms,anxiety/depression scores,and esophageal high⁃resolution manometry results were compared between the two groups.Results:There was a statistically significant difference in gender between NERD group and RE group(P<0.05).The self⁃rating anxiety scale(SAS)score was significantly higher in NERD group[44.00(29.00,58.00)]when compared with RE group[23.00(20.00,29.38)],the difference was statistically significant(P<0.01).However,there were no significant differences in self⁃rating depression scale(SDS),Hamilton anxiety scale(HAMA),or Hamilton depression scale(HAMD)scores between the two groups(P>0.05).Negative correlation was observed between distal contractile integral(DCI)and SAS score in GERD patients(P<0.05),but no correlation was found between DCI and SDS,HAMA and HAMD scores(P>0.05).Conclusions:Anxiety status in NERD patients is more obvious than that in RE patients.Furthermore,anxiety status is negatively correlated with DCI in GERD patients,suggesting that anxiety may be involved in the pathogenesis of GERD via influencing esophageal motility.