摘要
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 investigate night-time reflux symptom and its association with sleep disturbances in patients with gastroesophageal reflux disease （GERD）. Methods Seven thousand five hundred and twenty outpatients with GERD were studied by self-report questionnaires in 125 hospitals from 51 cities in China. Seven thousand five hundred and fifteen valid questionnaires were collected, and the male to female ratio was 1.36 ： 1. The items of questionnaires included reflux symptoms, night-time reflux symptoms, sleep disturbance and the association of night-time reflux and sleep disturbance. Results The main reflux symptoms in patients with GERD were heartburn （88. 3%）, regurgitation （72.2 % ）, chest pain （ 37. 6 % ）, epigastric pain （ 35. 50% ）, pharyngeal discomfort （ 30. 4 %）, chronic cough（ 12.1% ）, and asthma（ 3.0 % ）. Of 7515 patients, 4216（56.1% ） had night-time reflux symptoms. 56.1% of EE patients and 53.1% of NERD patients also had night-time reflux symptoms . There were no significant differences between EE and NERD patients. In patients with night-time reflux symptoms, 80.1% had sleep disturbances, which was significantly higher than those without night-time reflux symptoms（25.8 %）. Poor sleep quality（78.2 % ） and daytime sleepiness（70.1% ） were the most common sleep disturbances. The patients who had sleep disturbances occurred after night-time reflux symptoms accounted for 58. 7%, which was significantly higher than those（21. 5 %） occurred before night-time reflux symptoms. The incidence of sleep disturbances in patients with EE or NERD was 80. 0% or 77.1% respectively, and there was no statistical difference between EE or NERD patients（P 〉 0.05）. In GERD patients with sleep disturbances PPI was the most commonly selected medication（53.80%）, followed by hypnotic（24.5%） and the combination of PPI with hypnotic（9.5%）. Conclusions Night-time reflux symptoms are common in patients with GERD which may causes sleep disturbances. PPI may be the effective medication.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2007年第12期828-831,共4页
Chinese Journal of Digestion
关键词
胃食管反流病
睡眠障碍
夜间酸反流
Gastroesophaged reflux disease
Sleep distordeds
Nocturnal gastric acid reflux
