海南西部地区胃食管反流病患者的临床特征及相关危险因素研究

摘要

Objective To investigate the clinical characteristics and related risk factors in patients with gastro-esophageal reflux disease (GERD) in western region of Hainan. Methods We chose 1048 patients with GERD (obser- vation group) and 982 patients without GERD (control group) from the Outpatient Department and Digestive Depart-ment from Danzhou, Lingao, Qiongzhong, Baisha, Chengmai, Ledong and Changjiang counties. Reflux Disease Ques-tionnaire (RDQ) was used for investigation, and single factor analysis was applied to select the significant statistical vari-ables for multivariate Logistic regression analysis. Results GERD patients were mainly from Danzhou and Lingao re-gion, and the constituent ratio was 29.5% and 19.4%, respectively. The incidence of esophageal symptoms like heart-burn, acid regurgitation, chest pain and dysphagia in observation group was significantly higher than that in control group (P<0.01). The incidence of extraesophageal symptoms like hoarseness, pharynx ministry unwell, or foreign body sensation, cough at night, asthma and dyspnea at night in observation group was significantly higher than that in control group (P<0.01). Single factor analysis showed that body mass index (BMI), heavy drinking, family history of gastric can-cer, bile reflux, hiatal hernia, constipation, satiation, eating greasy food, spicy diet and high salt diet were statistically sig-nificant variables (P<0.05). Multivariate logistic regression analysis showed that heavy drinking, bile reflux, hiatus her-nia, constipation and satiation were independent risk factors for GERD, whose OR value and 95%CI were 2.617 (2.524 to 2.693), 3.648 (3.319 to 4.185), 9.485 (7.653 to 11.820), 3.387 (3.296 to 3.463), 2.415 (2.327 to 2.496), respectively. Conclusion The incidence of esophageal symptoms and extraesophageal symptoms in patients with GERD were high-er in western region of Hainan. Large number of drinking, bile reflux, hiatal hernia, constipation and satiation were inde-pendent risk factors for GERD.%目的 探讨海南西部地区胃食管反流病(GERD)患者的临床特征及相关危险因素.方法 选择儋州、临高、琼中、白沙、澄迈、乐东、昌江等县市医院门诊及消化科诊断为GERD患者1048例(观察组)和非GERD患者982例(对照组),采用反流性疾病问卷(RDQ)进行调查,应用单因素分析筛选出有意义的统计学变量后对其进行多元Logistic回归分析,筛选出GERD的独立危险因素.结果 GERD患者主要来自儋州和临高地区,构成比为29.5%和19.4%;观察组患者的烧心、反酸、胸痛和吞咽困难发生率明显高于对照组,差异均有显著统计学意义(P<0.01);观察组患者的声音嘶哑、咽部不适或异物感、夜间咳嗽、夜间哮喘和呼吸困难发生率明显高于对照组,差异均有显著统计学意义(P<0.01);单因素分析结果显示,两组患者的体质指数、大量饮酒、胃肠肿瘤家族史、胆汁反流、食管裂孔疝、便秘、过饱食、摄入油腻食物、辛辣饮食及高盐饮食比较差异均有统计学意义(P<0.01);Logistic多元回归分析结果显示,大量饮酒、胆汁反流、食管裂孔疝、便秘及过饱食是发生GERD的独立危险因素,其OR值及95%CI分别为2.617(2.524~2.693)、3.648(3.319~4.185)、9.485(7.653~11.820)、3.387(3.296~3.463)、2.415(2.327~2.496).结论 海南西部地区GERD患者食管症状和食管外症状发生率较高,大量饮酒、胆汁反流、食管裂孔疝、便秘及过饱食是其独立危险因素.