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目的研究胃食管反流病(GERD)患者夜间反流症状、睡眠障碍的发生率及相互关系。方法全国51个城市的125家医院对7520例门诊GERD患者进行问卷调查。获得有效问卷7515份,男、女比例为1.36:1。调查项目包括:GERD症状、夜间反流症状发生率、睡眠障碍的表现及夜间反流与睡眠障碍的关系。结果GERD主要症状为烧心(88.3%)、反流(72.2%)、胸痛(37.6%)、上腹痛(35.5%)、咽部不适(30.4%)、咳嗽(12.1%)及哮喘(3.0%)。7515例患者中,有夜间症状者4216例(56.1%),经内镜证实的糜烂性食管炎(EE)及非糜烂性胃食管反流病(NERD)患者夜间反流症状发生率分别为56.1%及53.1%,两者间差异无统计学意义(P>0.05)。有夜间反流症状者80.1%存在睡眠障碍,明显高于无夜间反流症状者的25.8%(P<0.01)。在睡眠障碍中,以睡眠质量下降和日间残留效应为多(分别为78.2%和70.1%),有夜间反流症状者,睡眠障碍病程发生在反流症状之后的占58.7%,明显高于发生在反流症状之前的21.5%(P<0.01)。有夜间反流的EE及NERD患者的睡眠障碍发生率分别为80.0%及77.1%两者间差异无统计学意义(P>0.05)。在治疗GERD伴睡眠障碍方案中以质子泵抑制剂治疗为主(53.8%),其次为安眠药(24.5%),联合用药(9.5%)。结论GERD患者常有夜间反流症状及睡眠障碍,夜间反流可能是患者睡眠障碍的原因,治疗中应合并使用质子泵抑制剂。
Objective To study the incidence of nighttime reflux symptoms and sleep disorders in patients with gastroesophageal reflux disease (GERD) and their relationship. Methods A total of 7520 outpatient GERD patients were surveyed in 125 hospitals in 51 cities in China. Obtain valid questionnaires 7515, male and female ratio of 1.36: 1. Survey items include: GERD symptoms, incidence of nocturnal reflux symptoms, performance of sleep disorders and nocturnal reflux and sleep disorders. Results The main symptoms of GERD were heartburn (88.3%), reflux (72.2%), chest pain (37.6%), upper abdominal pain (35.5%), throat discomfort (30.4%), cough (12.1%) and asthma . Of 7515 patients, 4216 (56.1%) had nocturnal symptomatology, 56.1 (n = 56.1) were endorhidiform encephalitis (EE) and non-erosive gastroesophageal reflux disease (NERD) % And 53.1%, respectively, with no significant difference (P> 0.05). There were 80.1% of patients with nighttime reflux symptoms of sleep disorders, significantly higher than those without nighttime reflux symptoms 25.8% (P <0.01). Among sleep disorders, sleep quality declines and daytime residual effects are much higher (78.2% and 70.1%, respectively), those with nighttime reflux symptoms, and those with sleep disorders occurring after reflux symptoms are significantly higher than those with reflux symptoms Occurred 21.5% before reflux symptoms (P <0.01). The incidence of sleep disorders in patients with nocturnal reflux of EE and NERD was 80.0% and 77.1%, respectively, with no significant difference (P> 0.05). In the treatment of GERD with sleep disorders program proton pump inhibitor therapy (53.8%), followed by sleeping pills (24.5%), combination therapy (9.5%). Conclusion GERD patients often have nocturnal reflux symptoms and sleep disorders. Nocturnal reflux may be the cause of sleep disorders in patients. Proton pump inhibitors should be used together in the treatment.