胃食管反流性咳嗽患者精神心理因素与食管动力的相关性研究  

A Correlation Study between Psychological Factors and Esophageal Motility of Patients with Gastroesophageal Reflux Cough

作　　者：王巍[1,2] 崔立红[2] 王晓辉[2] 弓三东 李超[2] 贺星[2] 冯博[3] 

机构地区：[1]解放军医学院研究生队,北京100853 [2]海军总医院消化内科,北京100048 [3]海军总医院信息科,北京100048

出　　处：《解放军医药杂志》2016年第8期28-30,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：首都市民健康项目培育(Z131100006813009)

摘　　要：目的调查胃食管反流性咳嗽(GERC)患者精神心理状况,探讨其与食管动力的相关性。方法对海军总医院确诊的196例GERC患者行高分辨率食管测压检查,并根据抑郁自评量表(SDS)、焦虑自评量表(SAS)得分情况将其分为4组。A组无焦虑、抑郁,B组轻度焦虑、抑郁,C组中度焦虑、抑郁,D组重度焦虑、抑郁,观察不同类型、不同程度的精神心理状况对GERC患者食管动力的影响。结果 78.1%的GERC患者有不同程度的焦虑、抑郁;焦虑、抑郁的GERC患者食管下括约肌(LES)静息压、远端收缩积分(DCI)下降更明显;大型蠕动中断百分比增加更明显;焦虑、抑郁情况越重以上指标差异越明显,结果均有统计学意义(P<0.05)。结论 GERC患者焦虑、抑郁发病率高,精神心理状态与食管动力之间存在相关性,随着焦虑、抑郁状态加重,食管下端LES静息压及食管运动功能降低。Objective To investigate psychological conditions of patients with gastroesophageal reflux cough（ GERC）,and to study correlation between psychological factors and esophageal motility of GERC patients. Methods A total of 196 GERC patients underwent detection of high resolution manometry,and the patients were divided into four groups according to self-rating depression scale（ SDS） and self-rating anxiety scale（ SAS） scores. Patients without anxiety and depression were in group A; patients with mild anxiety and depression were in group B; patients with moderate anxiety and depression were in group C; patients with severe anxiety and depression were in group D. Effects of different types and degrees of psychological conditions on esophageal motility of GERC patients were analyzed. Results Different levels of anxiety and depression were found in 78. 1% of GERC patients. GERC patients with anxiety and depression had much lower levels of lower esophageal sphincter（ LES） resting pressure and distal contractile integral（ DCI）; percentage of large peristaltic breaks increased more obviously. The more serious the anxiety and depression were,the more obvious the differences were,and the differences were statistically significant（ P 〈0. 05）. Conclusion GERC patients have a high incidence rate of anxiety and depression,and psychological conditions correlate with esophageal motility in GERC patients. With aggravating symptoms of anxiety and depression of GERC patients,values of esophageal LES resting pressure and esophageal motility function decrease.

关 键 词：胃食管反流性咳嗽 高分辨率食管测压 精神心理 焦虑 抑郁 食管动力 

分 类 号：R571[医药卫生—消化系统]