摘要
目的:分析胃食管反流病(gastroesophageal reFLux disease,GERD)患者的体质量指数(body mass index,BMI)、食管裂孔疝(hiatal hernia,HH)与胃食管反流(包括症状、食管炎)的关系.方法:收集2008-06/2011-10期间我院就诊的GERD患者590例.反流性疾病问卷(reflux disease questionnaire,RDQ)评价患者的胃食管反流症状,胃镜诊断糜烂性食管炎(erosive esophagitis,EE)、非糜烂性反流病(non-erosive reflux disease,NERD)、HH.根据BMI将患者分为4组:体质量过轻(BMI<18.5kg/m2)、正常体质量(18.5-22.9kg/m2)、超质量(23.0-24.9kg/m2)、肥胖(≥25kg/m2).分析GERD患者的临床特点、HH与BMI的关系、BMI及HH与GERD症状及EE的关系.结果:(1)临床特征:590例患者RDQ积分13.33±5.66,EE占52.2%(308/590),平均BMI为(23.64±3.10)kg/m2,体质量过轻、正常、超质量及肥胖组患者所占的比例分别为3.7%(22/590)、37.0%(218/590)、23.7%(140/590)、35.6%(210/590);(2)BMI与HH:体质量过轻、正常、超质量及肥胖组HH的检出率分别为0、6.0%(13/218)、12.9%(18/140)、16.7%(35/210),差异有统计学意义(P=0.001);(3)BMI、HH与GERD症状:体质量过轻、正常、超质量、肥胖4组的RDQ积分依次为11.95±5.86、13.33±5.50、13.45±5.22、13.40±6.07(F=0.465,P=0.707);HH组RDQ积分平均值高于无HH组(17.36±6.66vs12.83±5.31,P=0.005),且多元线性回归分析后差异仍有统计学意义(P=0.000);(4)BMI、HH与EE:EE组超质量、肥胖患者的比例明显高于NERD组(P=0.000);HH组EE的检出率高于无HH组(P=0.000).多因素分析后发现BMI、HH是EE发生危险因素.结论:HH可能是肥胖患者发生EE的重要机制之一.GERD患者的症状严重程度与HH相关,而与BMI无关,BMI和HH均是EE发生的危险因素.
AIM： To analyze the relationship between body mass index （BMI）, hiatal hernia （HH） and gas- troesophageal reflux （including symptoms and esophagitis） in patients with gastroesophageal reflux disease （GERD）. METHODS： Five hundred and ninety patients diagnosed with GERD at our hospital from June 2008 to Oct 2011 were included in the study. Gastroesophageal reflux symptoms were as- sessed using the Reflux Disease Questionnaire （RDQ）. Erosive esophagitis （EE）, non-erosive reflux disease （NERD）, and hiatal hernia （HH） were diagnosed by gastroscopy. Patients were categorized into four groups according to BMI： underweight （BMI 〈 18.5 kg/m^2）, normal weight （18.5-22.9 kg/m^2）, overweight （23.0-24.9 kg/m^2）,and obesity （I〉 25 kg/m2）. The clinical charac- teristics of GERD, relationship between HH and BMI, between BMI/HH and symptoms, and be- tween BMI/HH and EE were analyzed. RESULTS： RDQ score was 13.33± 5.66. EE ac- counted for 52.2% （308/590）. BMI was （23.64＋ 3.10） kg/m^2. The percentages of underweight, normal, overweight and obese patients were 3.7% （22/590）, 37.0% （218/590）, 23.7% （140/590） and 35.6% （210/590）, respectively. The incidences of HH were 0, 6.0% （13/218）, 12.9% （18/140）, and 16.7% （35/210） in underweight, normal, over- weight and obese patients, respectively, with a significant difference among these patients （P = 0.001）. RDQ scores of underweight, normal, overweight, and obese patients were 11.95± 5.86, 13.33 ±5.50, 13.45±5.22 and 13.40±6.07, respectively （F = 0.465, P = 0.707）. RDQ scores were significantly higher in the HH group （17.36 ＋ 6.66） than in the non-HH group （17.36±6.66 vs 12.83±5.31, P = 0.005, and multivariate analysis showed a significant difference （P = 0.000）. The percentage of overweight and obese patients in the EE group was significantly higher than that in the NERD group （P = 0.000）. The number of HH patients who suffered from EE was more than that of pat
出处
《世界华人消化杂志》
CAS
北大核心
2012年第34期3375-3379,共5页
World Chinese Journal of Digestology
关键词
胃食管反流病
体质量指数
食管裂孔疝
Gastroesophageal reflux disease
Bodymass index
Hiatal hernia
