乌鲁木齐市维吾尔族人群胃食管反流症状的流行病学调查及防治  

Symptomatic gastroesophageal reflux disease among Uygur residents in Urumqi: An epidemiological study and preventive treatment

作　　者：荣亮[1] 李可[1] 郑森元[1] 刘芳[2] 刘慧敏[1] 侯慧[1] 

机构地区：[1]新疆医科大学第五附属医学院消化科 [2]新疆医科大学第五附属医学院老年病科

出　　处：《世界华人消化杂志》2013年第33期3715-3719,共5页World Chinese Journal of Digestology

摘　　要：目的:了解乌鲁木齐市维吾尔族人群胃食管反流病(gastroesophageal reflux disease,GERD)和反流性食管炎(reflux esophagitis,RE)在2013-02/2013-04调查时的患病率及其相关危险因素,并选取部分患者进行干预治疗.方法:(1)对本市区18-78岁维吾尔族常住人口进行整群、分层、随机抽样的问卷调查,样本量为3000例,完成者2980例.根据胃食管反流病问卷(gastroesophageal reflux disease questionnaire,GerdQ)行症状积分(症状积分分值最高18分),症状积分分值≥8表明存在症状性反流,并且将症状积分分值≥8的人群作为观察组,症状积分分值<8的人群作为对照组;随机抽取观察组与对照组部分反流阳性的患者进行胃镜、24 h pH值监测等作精查,根据精查的正确率对普查结果校正后测算出患病率;(2)采用多因素Logistic回归分析影响症状性反流的因素;(3)确诊为GERD的53例患者被随机分为埃索美拉唑组(A组)、西米替丁组(B组)和改变生活方式组(C组),治疗4 wk后比较症状改善情况.结果:(1)共2980例完成筛查,男女之比为1.07∶1,样本中症状积分分值≥8者468例(15.60%),精查正确率为72.86%,据此推算GERD的患病率为11.44%,RE为2.92%;(2)高脂饮食[优势比(odds ratio,OR)=7.964]、饮酒(OR=3.804)、饮浓茶(OR=2.758)、腹型肥胖(OR=2.713)、饱食(OR=2.408)、幽门螺杆菌感染(OR=0.186)与胃食管反流症状存在相关性;(3)埃索美拉唑组(A组)、西米替丁组(B组)和改变生活方式组(C组)干预治疗4 wk后,症状改善率分别为88.24%、47.06%和26.32%.结论:GERD为多发疾病,高脂饮食、饮酒、饮浓茶、腹型肥胖、饱食是GER的危险因素,幽门螺杆菌感染是GER的保护因素.改变饮食习惯及生活方式对控制胃食管反流症状有益.AIM： To explore the prevalence of symptomatic gastroesophageal reflux disease （GERD） and reflux esophagitis （RE） in a Uygur adult popula- tion in Urumqi, to identify the risk factors for GERD, and to explore the preventive treatment of this disease in some patients. METHODS： A total of 3000 Uygur residents aged from 18 to 78 years old were studied, and2980 patients completed the study. This study was performed by clustering, stratifying and simple random sampling. Symptom scores were calculated using the GerdQ scale （the high- est score is 18）. GerdQ score ≥ 8 indicated the presence of symptomatic GERD. Subjects with a GerdQ score ≥ 8 were included in the obser- vation group, and those with a GerdQ score 〈 8 were assigned to the control group. A case- control study was also performed in some sub- jects to confirm the diagnosis of GERD and RE. Multivariable logistic regression analysis was performed to analyze risk factors for GERD. In addition, 53 subjects with GERD were divided into an esomeprazole group, a cimetidine group, and a lifestyle changes group to receive 4 wk of treatment, and the treatment effects were com- pared. RESULTS： Of 2980 subjects who completed the survey, 468 （15.6%） had symptomatic GER （GerdQ score ≥ 8）, and the male-to-female ratio was 1.07：1. The correct incidence was 72.86%. Estimated prevalence for GERD and RE was 11.44% and 2.92%, respectively. High-fat diet （OR = 7.964）, drinking （OR = 3.804）, drinking strong tea （OR = 2.758）, abdominal obesity （OR = 2.713）, greasy food （OR =2.408） and Helicobacter pylori infection （OR = 0.186） were factors associated with the development of GERD. The rates of symptom improvement for the esomeprazole group, cimetidine group and lifestyle change group were 88.24%, 47.06% and 26.32%, respec- tively. CONCLUSION： GERD is a multi-factorial dis- ease. High-fat diet, drinking, drinking strong tea, abdominal obesity, and greasy food are risk factors for GERD, while Helicobacter pylori infec- tion

关 键 词：维吾尔族 胃食管反流病 反流性食管炎 

分 类 号：R571[医药卫生—消化系统]