山东地区农民反流性食管炎相关危险因素的研究  

The risk factors of reflux esophagitis in Shandong farmers

作　　者：张莉[1] 周丽雅[1] 林三仁[1] 丁士刚[1] 黄永辉[1] 顾芳[1] 李渊[1] 张静[1] 闫秀娥[1] 孟灵梅[1] 张冬红[1] 金珠[1] 崔荣丽[1] 黄淑美 曲学富 

机构地区：[1]北京大学第三医院消化科,100083 [2]山东烟台牟平区人民医院 [3]山东烟台牟平区高陵镇医院

出　　处：《中华内科杂志》2007年第11期895-898,共4页Chinese Journal of Internal Medicine

摘　　要：目的进行农民反流性食管炎(RE)发病相关危险因素的调查。方法 2006年5月对山东烟台牟平区高陵镇常住农民进行胃镜及病理组织学检查及症状危险因素调查。结果共调查556例,男性269例,女性287例。年龄34～90(60.7±8.15)岁。内镜发现糜烂性 RE 101例(18.2%);其中洛杉矶分级 A 级37例,B 级57例,C 级3例,D 级4例。RE 在男性中比例更高(P<0.001);患者年龄(P=0.041)、务农时间(P=0.040)、Z 线距离门齿的长度(P=0.001)与发病有相关性。吸烟(OR 1.894,95%CI 1.207～2.974)、饮浓茶(OR 2.900,95%CI 1.651～5.092)、使用非甾体类抗炎药(NSAIDs)(OR 2.159,95%CI 1.166～3.997)、贲门松弛(OR 13.630,95%CI 7.370～25.190)是发病危险因素。而身高、体重、腹围、体重指数、饮酒、特殊饮食习惯、糖尿病、腹部手术史等与之无关(P>0.05)。RE 组合并消化性溃疡的患者12例,高于非 RE 组;RE 组合并胃体萎缩的患者14例,少于非 RE 组,但均未达到统计学意义。本组总调查人群幽门螺杆菌(Hp)感染率为51.3%(273/556),RE 组为37.1%(36/97),非 RE 组为54.5%(237/435)(P=0.002)(OR 0.492,95%CI0.313～0.776)。多因素分析显示,男性、Z 线距门齿长度短、贲门松弛、服用 NSAIDs 是 RE 发病的危险因素,而 Hp 感染可减少 RE 的发病。结论男性、高龄、Z 线距门齿长度短、贲门松弛、无 Hp 感染等因素与 RE 的发病有相关性,吸烟、饮浓茶、服用 NSAIDs、务农时间长是发病的危险因素。Objective To investigate the risk factors of reflux esophagitis （RE） in farmers of Shandong province. Methods Five hundred and fifty six peasants （ aged from 34 to 90 years old） were randomly selected from the rural general population in Yantai area, Shandong province. All participants received a face to face interview for relating clinical symptoms. Upper gastrointestinal endoscopic and histopathologic examination were carried out. Results 101 （18.2%） patients were diagnosed endoscopicaUy as RE. According to Los Angeles Classification system, the distribution of types was as follows ： A ：36. 6% （37/101）, B ： 56.4% （ 57/101 ）, C ： 3. 0% （ 3/101 ）, D ： 4. 0% （4/101）. The gender （P 〈0. 001 ）, age （P =0. 041 ）, time engaged in farming（P =0. 040） of the subjects and the length from Z line to fore-tooth （P =0. 001 ） were correlated with the occurrence of RE. Smoking （ OR 1. 894, 95% CI 1. 207-2. 974）, drinking strong tea （ OR 2. 900, 95% C! 1. 651-5.092 ）, using non-steroidal antiinflammatory drugs （NSAIDs） （ OR 2. 159, 95% CI 1. 166-3.997） and loose cardia （ OR 13. 630, 95% CI 7.37-25.19） were risk factors of RE. But there was no relationship between RE and the height, body weight, abdominal circumference, body mass index （BMI）, alcohol drinking, special food habit and the history of diabetes, previous abdominal operation, peptic ulcer and atrophic gastritis of the subjects. H. pylori infection rate in the population was 51.3% （273/532）. 37. 1% （36/97） of RE patients and 54. 5 % （237/435） of non-RE patients were H. pylori positive （ P = 0. 002 ）, OR 0. 492 （ 95 % CI 0. 313-0. 776）. Conclusions Male gender, aging, shorter length from Z line to fore tooth, loose cardia and absence of H. pylori infection were correlated with RE. Smoking, drinking strong tea, NSAIDs and long time engaged in farming were risk factors of RE.

关 键 词：反流性食管炎 危险因素 农民 

分 类 号：R571[医药卫生—消化系统]