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...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。展开更多
The extraesophageal manifestations of gastroesophageal reflux disease that are similar to a heart attack or gastric diseases are well known, while those categorized as pulmonary or otolaryngological are less known and...The extraesophageal manifestations of gastroesophageal reflux disease that are similar to a heart attack or gastric diseases are well known, while those categorized as pulmonary or otolaryngological are less known and less studied. In this article, we introduce this less known aspect of gastroesophageal reflux.展开更多
AIM:To investigate the impact of esophagogastroduodenoscopy with conscious sedation on the subsequent 24-h catheter-based pH monitoring.METHODS:Fifty patients with extra-esophageal symptoms of gastroesophageal reflux ...AIM:To investigate the impact of esophagogastroduodenoscopy with conscious sedation on the subsequent 24-h catheter-based pH monitoring.METHODS:Fifty patients with extra-esophageal symptoms of gastroesophageal reflux disease undergoing ambulatory dual-probe 24-h pH monitoring were enrolled from March 2010 to August 2011.All of the data were collected prospectively and analyzed retrospectively.Thirty-six patients(72%,group A) underwent pH monitoring shortly after esophagogastroduodenoscopy(EGD) with conscious sedation,and 14 patients(28%,group B) underwent pH monitoring without conscious sedation.The 24-h pH data from two time periods were analyzed:the first 4 h(Period Ⅰ) and the remaining time of the study(Period Ⅱ).RESULTS:The mean age of the patients was 49.6 ± 12.5 years;20 patients(40%) were men.The baseline data,including age,sex,body mass index,reflux esophagitis,the Reflux Symptom Index,and the Reflux Findings Score,were comparable between the two groups.The percentage of total time with a pH < 4 and the frequency of acid reflux during Period Ⅰ were not significantly different between the two groups,as measured using both pharyngeal(0.03% ± 0.10% vs 0.07% ± 0.16%,P = 0.32;and 0.07 ± 0.23 episodes/h vs 0.18 ± 0.47 episodes/h,P = 0.33,respectively) and esophageal probes(0.96% ± 1.89% vs 0.42% ± 0.81%,P = 0.59;and 0.74 ± 1.51 episodes/h vs 0.63 ± 0.97 episodes/h,P = 0.49,respectively).The percentage of total time with a pH < 4 and the frequency of acid reflux were also not significantly different between Periods I and Ⅱ in group A patients,as measured using both pharyngeal(0.03% ± 0.10% vs 0.23% ± 0.85%,P = 0.21;and 0.07 ± 0.23 episodes/h vs 0.29 ± 0.98 episodes/h,P = 0.22,respectively) and esophageal probes(0.96% ± 1.89% vs 1.11% ± 2.57%,P = 0.55;and 0.74 ± 1.51 episodes/h vs 0.81 ± 1.76 episodes/h,P = 0.55,respectively).CONCLUSION:EGD with conscious sedation does not interfere with the results of subsequent 24-h pH monitoring in patients with extra-esophageal symptoms of gastroesoph展开更多
文摘背景近年来,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。
文摘The extraesophageal manifestations of gastroesophageal reflux disease that are similar to a heart attack or gastric diseases are well known, while those categorized as pulmonary or otolaryngological are less known and less studied. In this article, we introduce this less known aspect of gastroesophageal reflux.
基金Supported by A Grant from Chang Gung Memorial Hospital,CMRPG300011
文摘AIM:To investigate the impact of esophagogastroduodenoscopy with conscious sedation on the subsequent 24-h catheter-based pH monitoring.METHODS:Fifty patients with extra-esophageal symptoms of gastroesophageal reflux disease undergoing ambulatory dual-probe 24-h pH monitoring were enrolled from March 2010 to August 2011.All of the data were collected prospectively and analyzed retrospectively.Thirty-six patients(72%,group A) underwent pH monitoring shortly after esophagogastroduodenoscopy(EGD) with conscious sedation,and 14 patients(28%,group B) underwent pH monitoring without conscious sedation.The 24-h pH data from two time periods were analyzed:the first 4 h(Period Ⅰ) and the remaining time of the study(Period Ⅱ).RESULTS:The mean age of the patients was 49.6 ± 12.5 years;20 patients(40%) were men.The baseline data,including age,sex,body mass index,reflux esophagitis,the Reflux Symptom Index,and the Reflux Findings Score,were comparable between the two groups.The percentage of total time with a pH < 4 and the frequency of acid reflux during Period Ⅰ were not significantly different between the two groups,as measured using both pharyngeal(0.03% ± 0.10% vs 0.07% ± 0.16%,P = 0.32;and 0.07 ± 0.23 episodes/h vs 0.18 ± 0.47 episodes/h,P = 0.33,respectively) and esophageal probes(0.96% ± 1.89% vs 0.42% ± 0.81%,P = 0.59;and 0.74 ± 1.51 episodes/h vs 0.63 ± 0.97 episodes/h,P = 0.49,respectively).The percentage of total time with a pH < 4 and the frequency of acid reflux were also not significantly different between Periods I and Ⅱ in group A patients,as measured using both pharyngeal(0.03% ± 0.10% vs 0.23% ± 0.85%,P = 0.21;and 0.07 ± 0.23 episodes/h vs 0.29 ± 0.98 episodes/h,P = 0.22,respectively) and esophageal probes(0.96% ± 1.89% vs 1.11% ± 2.57%,P = 0.55;and 0.74 ± 1.51 episodes/h vs 0.81 ± 1.76 episodes/h,P = 0.55,respectively).CONCLUSION:EGD with conscious sedation does not interfere with the results of subsequent 24-h pH monitoring in patients with extra-esophageal symptoms of gastroesoph
