胃食管反流病与功能性消化不良、肠易激综合征症状重叠的研究  

Overlapping between gastroesophageal reflux disease,functional dyspepsia and irritable bowel syndrome

作　　者：元刚[1] 彭穗[1] 肖英莲[1] 陶金[1] 熊理守[1] 林金坤[1] 胡品津[1] 陈旻湖[1] 

机构地区：[1]中山大学附属第一医院消化内科,广州510080

出　　处：《中华消化杂志》2007年第5期291-294,共4页Chinese Journal of Digestion

摘　　要：目的探讨胃食管反流病(GERD)重叠功能性消化不良(FD)、肠易激综合征(IBS)症状的发生率,分析糜烂性食管炎(EE)和非糜烂性反流病(NERD)亚型患者重叠FD、IBS症状发生率的异同。方法通过胃镜及24 h食管pH监测,将147例GERD患者区分为EE 47例、病理性酸反流[NERD pH (+)]42例和生理性酸反流[NERD pH(-)]58例。根据罗马Ⅱ诊断标准对患者重叠FD、IBS症状的情况进行问卷调查。采用X^2检验比较不同组间重叠症状发生率。结果147例GERD患者中重叠FD症状54例(36.7%),重叠IBS症状19例(12.9%),其中同时重叠FD、IBS症状10例(6.8%)。EE及NERD组重叠FD症状者分别为11例(23.4%)及43例(43.0%),差异有统计学意义(P<0.05)。EE及NERD pH(+)组重叠FD症状者分别为11例(23.4%)及13例(31.0%),差异无统计学意义(P>0.05)。NERD pH(+)组及pH(-)组重叠FD症状者分别为13例(31.0%)及30例(51.7%),差异有统计学意义(P<0.05)。EE及NERD组重叠IBS症状者分别为6例(12.8%)及13例(占13.0%),差异无统计学意义(P>0.05)。NERD pH(+)组及pH(-)组重叠IBS症状者分别为4例(9.5%)及9例(15.5%),差异无统计学意义(P>0.05)。结论部分GERD患者重叠FD、IBS症状。无异常食管酸暴露的烧心患者易合并FD症状。Objective To evaluate the prevalence of symptomatic overlapping between gastro- esophageal reflux disease （GERD）, functional dyspepsia （FD）, and irritable bowel syndrome（IBS）, and the prevalences of erosive esophagitis, or sub-type of non-erosive reflux disease （NERD） among FD and IBS. Methods One hundred and forty-seven GERD patients diagnosed by 24-hour pH-metry underwent upper endoscope examination. Forty-seven patients had erosive esophagitis （EE）, 42 patients had non- erosive reflux disease （NERD） with pathological acid reflux [-pH（＋）], and 58 patients had NERD without pathological acid reflux [-pH（-）]. Patient questionnaires were performed by physicians. The patients were screened for FD, IBS symptoms according to Rome Ⅱ criteria. Results Among 147 GERD patients, 54 （36. 7%） patients had FD symptoms, 19 （12. 9%） patients fulfilled IBS criteria, and 10 （6.8%） patients had both FD symptoms and IBS symptoms. There was significant difference between the overlap of the symptoms of FD with EE and that with NERD [11（23.4%） versus 43（43.0%）, P〈0.05]. But there was no significant difference between EE and NERD pH（＋） patients[11 （23.4 % ） versus 13（31.0%）, P〉 0.05]. There was significant difference between the overlap of symptoms of FD with NERD pH（＋） and that with pH（-） patients[13（31.0%） versus 30（51.7%）, P 〈 0.05]. There was no significant difference in the overlap IBS symptoms between EE and NERD patients[6 （12.8 %） versus 13（13.0%）, P 〉 0.05], and there was no significant difference between NERD pH（＋） and NERD pH（-） patients[4（9.2%） versus 9（15.5%）, P 〉 0.05]. Conclusions The symptoms of some patients with GERD overlap with FD and/or IBS. Patients with heartburn and normal acid exposure time may be more likely to suffer from FD.

关 键 词：胃食管反流 食管炎 消化性 肠易激综合征 重叠 

分 类 号：R57[医药卫生—消化系统]