胃食管反流病患者的临床特征及其影响因素分析

目的分析胃食管反流病(GERD)患者的临床特征以及影响其发生的因素。方法选取深圳市龙岗区横岗人民医院消化内科2011年5月-2013年5月收治的GERD患者146例作为观察组,另选取148例非GERD患者为对照组,探讨其发病的危险因素。结果 GERD患者发生率最高的6项相关症状为反酸、烧心、上腹部不适、吞咽困难、胸痛、胸骨后不适;治疗前观察组Gerd Q得分显著高于对照组(10.63±2.87 vs 4.02±1.81,P0.05),Gerd Q得分自治疗2周后开始与治疗前比较,差异有显著统计学意义(P0.01);后期有消化道外症状的患者(72例)进行消化道外症状(EED)问卷分析,发现观察组自治疗后4周显著改善,差异有显著统计学意义(P0.01);单因素分析显示GERD影响因素包括:年龄、职业、BMI、腰围、辛辣饮食、高盐饮食、H.pylori感染、吸烟、饮酒、便秘。Logistic多元回归分析显示GERD的危险因素由大到小依次为辛辣饮食、年龄、便秘和职业(OR值分别为4.928、3.673、3.452、3.082)。结论 GERD的临床表现以反酸、烧心、上腹部不适等为主,也会表现出EED的症状;养成良好的饮食习惯、保持肠道畅通、戒烟戒酒、注意锻炼和放松等都能够有效预防和减少GERD的发生。

Clinical features and influence factors of patients with gastroesophageal reflux disease

Objective To investigate the clinical features and influence factors of gastroesophageal reflux disease （GERD） patients.Methods One hundred and forty-six GERD patients were selected as the observation group from May 2011 to May 2013,one hundred and forty-eight non-GERD patients were selected group control group.The clinical features and influence factors were analyzed.Results Six related symptoms of highest incidences were acid reflux,heartburn,epigastric discomfort,dysphagia,chest pain,chest discomfort.Before the treatment,Q score of GerdQ in the observation group was significantly higher than that in the control group （10.63 ± 2.87 vs 4.02 ± 1.81,P ＜ 0.05）,score of GerdQ after two weeks＇ treatment was better than before treatment （P ＜0.01）.Patients with symptoms of EED （72 cases） after treatment four weeks began to improve by EED questionnaire analysis,there were statistically significant differences （P ＜ 0.01）.Univariate analysis showed that influencing factors included age,occupation,BMI,waist circumference,spicy diet,high salt diet,H.pylori infections,smoking,drinking and astriction.Logistic multivariate regression analysis showed that risk factors for GERD from big to small are spicy food,age,constipation and career.Conclusion The clinical manifestations of GERD were acid reflux,heartburn,epigastric discomfort,also showed the EED symptoms.Forming a good eating habits,keeping clear of the intestinal,quitting smoking and drinking and paying attention to exercise and relaxation can effectively prevent and reduce the occurrence of GERD.