食管外症状对胃食管反流病患者焦虑抑郁情绪、生活质量及治疗效果的影响研究

doi:10.12114/j.issn.1007-9572.2019.00.615

摘要/Abstract

摘要： 背景　近年来，随着胃食管反流病（GERD）的流行病学和病理生理学研究的深入，发现该病存在较高的焦虑抑郁发生率，其典型症状（反酸、胃灼热）常与患者的情绪密切相关。食管外症状是GERD常见的一类症候群，在一定程度上加重了患者的焦虑抑郁情绪，降低了患者的生活质量，并影响治疗效果。目的　通过对伴或不伴食管外症状GERD患者的症状、情绪、生活质量的调查，探讨食管外症状对GERD患者的情绪及生活质量的影响；并通过对经质子泵抑制剂（PPI）治疗8周后GERD患者的随访，探讨影响GERD治疗效果的危险因素。方法　于2018年1—12月，收集在门诊及住院患者1 013例进行问卷调查。采用胃镜、24 h pH监测及GerdQ量表诊断GERD；采用SAS、SDS量表评价患者焦虑抑郁情况；采用SF-36量表对生活质量进行评价。采用Logistic回归分析影响GERD治疗效果的危险因素。结果　本次调查共发放问卷1 013份，回收有效问卷937份，有效回收率92.5%。伴食管外症状GERD患者的焦虑抑郁发生率高于不伴食管外症状GERD患者（42.6%比33.1%）。随访经PPI治疗8周后的GERD患者，伴食管外症状合并焦虑抑郁患者的症状、焦虑抑郁情绪好转率低于其他组，差异有统计学意义（P<0.05）。多因素分析结果显示：体质指数、GERD亚型、是否合并焦虑抑郁、伴/不伴食管外症状是GERD患者治疗效果的影响因素。结论　食管外症状加重患者焦虑抑郁情绪的发生，降低生活质量，并影响治疗效果。

关键词: 胃食管反流, 难治性胃食管反流, 食管外症状, 焦虑, 抑郁, 生活质量

Abstract: Background　In recent years， along with the in-depth study of the epidemiology and pathophysiology of gastroesophageal reflux disease（GERD），it is found that GERD has a high incidence of anxiety and depression，and its typical symptoms（acid reflux， heartburn）are often closely related to the patient's mood.Extraesophageal symptoms are common types of GERD syndromes，which aggravate the anxiety and depression of patients，reduce their quality of life，and affect the treatment effect to some extent.Objective　By investigating the symptoms，emotions and quality of life of GERD patients with or without extraesophageal symptoms，the effects of extraesophageal symptoms on the emotions and quality of life of GERD patients were explored，and the risk factors of refractory GERD were explored through the follow-up of GERD patients after eight weeks of proton pump inhibitor（PPI） treatment.Methods　From January to December 2018，a questionnaire survey was conducted on 1 013 inpatients and outpatients.GERD was diagnosed by gastroscopy，24-hour PH monitoring and GERD-Q scale;anxiety and depression were evaluated by SAS and SDS scales;and quality of life was evaluated by SF-36 scale.Logistic regression was used to analyze the risk factors affecting the efficacy of GERD treatment.Results　A total of 1 013 questionnaires were distributed in this survey，and 937 valid questionnaires were returned with an effective recovery rate of 92.5%.The incidence of anxiety and depression in GERD patients with extraesophageal symptoms was higher than that in GERD patients without extraesophageal symptoms（42.6% vs 33.1%）.The improvement rate of symptoms，anxiety and depression status and quality of life in GERD patients with extraesophageal symptoms and anxiety and depression after PPI treatment was lower than that in other groups（P<0.05）.Multivariate analysis showed that BMI，GERD subtype, anxiety and depression, and/or absence of extraesophageal symptoms were the influencing factors for the therapeutic effect of GERD patients.Conclusion　Extraesophageal symptoms aggravate the occurrence of anxiety and depression in patients，reduces the quality of life of patients，and affects the therapeutic effect．

Key words: Gastroesophageal reflux, Refractory gastroesophageal reflux, Extraesophageal symptoms, Anxiety, Depression, Quality of life

欧阳皓,薛倩,王晶桐. 食管外症状对胃食管反流病患者焦虑抑郁情绪、生活质量及治疗效果的影响研究[J]. 中国全科医学, 2020, 23(7): 855-860. DOI: 10.12114/j.issn.1007-9572.2019.00.615.
OUYANG Hao,XUE Qian,WANG Jingtong. Effects of Extraesophageal Symptoms on the Anxiety and Depression，Quality of Life and Treatment Effect in Patients with Gastroesophageal Reflux Disease　[J]. Chinese General Practice, 2020, 23(7): 855-860. DOI: 10.12114/j.issn.1007-9572.2019.00.615.

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