难治性反流性食管炎相关危险因素分析

Analysis of risk factors associated with refractory reflux esophagitis

摘要:

目的：探讨难治性反流性食管炎（refractory reflux esophagitis，RRE）的相关危险因素。方法：反流性食管炎（reflux esophagitis，RE）门诊患者共212例，给予质子泵抑制剂（proton pump inhibitors，PPIs）治疗8周，临床症状无有效缓解的RRE患者93例（占总数的43.9%），临床症状能有效缓解的非难治性反流性食管炎（non-refractory reflux esophagitis，NRRE）患者119例（占总数的56.1%），对比分析RRE与NRRE患者的性别、年龄、体质指数（body mass index，BMI）、家族史、胃镜下分级、焦虑抑郁状况。结果：RRE组与NRRE组在年龄、BMI、病程、家族史方面存在统计学差异（P<0.05），而性别差异不显著（P ＞0.05），治疗前后RRE与NRRE患者在焦虑抑郁积分方面有统计学差异（P<0.05），而治疗前后RRE患者与NRRE患者胃镜分级评分无统计学差异（P ＞0.05）。logistic回归分析显示中老年、肥胖、存在RE家族史、长病程、临床症状及焦虑抑郁重是RRE的危险因素。结论：RRE与年龄、BMI、家族史、焦虑抑郁状态、病程等多种因素相关，中老年、肥胖者、有RE家族史者、病程长者、临床症状及焦虑抑郁状况严重者更易患RRE，RRE患者的临床严重程度与胃镜下的严重程度无平行关系。

Abstract:

Objective：To investigate the risk factors of refractory reflux esophagitis（RRE）. Methods：A total of 212 patients with reflux esophagitis（RE） who received proton pump inhibitors（PPIs） treatment for 8 weeks were enrolled including 93 RRE patients（43.9%）with ineffective treatment and 119 non-refractory reflux esophagitis（NRRE） patients（56.1%） with effective treatment. Clinical data （gender，age，body mass index（BMI），family history，endoscopy grading，anxiety and depression status） were collected and analyzed statistically. Results：There were statistical differences between RRE group and NRRE group in age，BMI，duration of disease，family history（P<0.05） while no significant difference in gender（P ＞0.05）. There were statistically significant differences in anx－iety and depression grading between RRE group and NRRE group before and after treatment（P<0.05） while no statistically significant difference in endoscopy grading（P ＞0.05）. Logistic regression analysis showed that middle-age，obesity，family history of RE，long dis－ease duration and clinical symptom and severe anxiety and depression were higher risk factors for RRE. Conclusion：RRE is related with age，BMI，family history，anxiety and depression status and disease duration. Middle-age，obesity，family history of RE，long dis－ease duration，severe anxiety and depression are risk factors of RRE. There is no parallel association between clinical severity and gas－troscopic severity for patients with RRE.