北京上海胃食管反流症状的流行病学调查【摘要】目的了解北京、上海成人胃食管反流病(GERD)和反流性食管炎(RE)，在1996年7～9月调查时一年内的患病率及其相关性疾病和危险因素等。方法对两市18～70岁城乡常住人口5000例，进行整群、分层、随机抽样的问卷调查。以反酸、烧心、反食症状程度和频度的积分(Sc,最高18分)作为反流的指标，Sc≥6表明存在症状性反流(GER)；再抽取一部分反流阳性病人和对照者用胃镜和24小时pH监测作精查，根据精查的正确率对普查结果校正后测算出患病率。结果(1)共4992例完成了筛查，人群中每日有烧心者占2.5%；Sc≥6者448例占8.97%，男女之比为1∶1.1；精查正确率为64%，据此推测GERD的患病率为5.77%，RE为1.92%。(2)分层分析显示，有反流症状者北京(10.19%)多于上海(7.76%)，北京的男性病人、体力劳动者及农村的患病率均高于上海；此外，40岁以上的患病率增多。(3)反流组伴发口咽喉病患、哮喘和支气管炎的频率比非病人人群明显为高。结论调查结果显示，GERD为多发病，但我国南北方的患病率有差别。GERD和RE的比值为3∶1。年龄(OR1.01)、饱食(OR1.99)、油腻食物(OR6.56)、劳累(OR2.35)、精神情绪(OR2.22)、妊娠(OR6.80)、排便困难(OR1.65)等因素和反流有密切关系。【关键词】反流胃食管反流病反流性食管炎AnepidemiologicstudyonsymptomaticGERinBeijingandShanghaiPANGuozong,XUGuoming,GUOHuiping,etal.PekingUnionMedicalCollegeHospital,Beijing100730,andChanghaiHospital,TheSecondMilitaryMedicalUniversity,Shanghai200433【Abstract】ObjectiveToexploretheoneyear-pointprevalences(Jul-Sep,1996)ofsymptomaticgastroesophagealreflux(GER),gastroesophagealrefluxdisease(GERD)andrefluxesophagitis(RE)amongadultpopulationinBeijingandShanghaiandtoidentifytheriskfactorsofGERD.Methods5000residencesofthetwocities,agebetween18-70werestudiedthroughquestionaire.Studywasdonebyclusteringsamplingfromcity,surburbanandruralareasusingsimplerandomsampling.Symptomscores(Sc)oftheintensityandfrequencyofheartburn,acidrefluxandregurgitationwithinoneyearatthetimeofstudyweretakenasindicesofacidreflux(highestSc=18)andSc≥6indicatedthepresenceofsymptomaticGER.AcasecontrolstudywasalsoperformedinsomesubjectsfromthesurveytoconfirmthediagnosisofGERDandREusinggastroscopyand24hpHmonitoring.AnestimationoftheprevalenceofGERDandREwasmadeonthebasisofcorrectdiagnosticratesofthediseases.Results(1)4992subjectscompletedthesurvey,2.5%ofthepeoplehadheartburnonceaday,448peopleaccountedfor8.97%ofthepopulationscreenedhadsymptomaticGER(Sc≥6),andmaletofemaleratiowas1∶1.1.EstimatedprevalencesforGERDandREwere5.77%and1.92%respectively.(2)StratifiedanalysisindicatedthattheprevalenceofsymptomaticGERinBeijing(10.19%)washigherthanthatinShanghai(7.76%),andtherewasalsoahigherprevalenceofGERinmale,inlaboringpeopleandinpeopleofruralareasinBeijingascomparedwithShanghai.(3)LogisticanalysisindicatedthatGERhadacloserelatioshipwithdental,pharnyngo-laryngealdisordersandrespiratorydiseases,suchasasthmaandbronchitis,etc.ConclusionsGERDisdifferentinthenorthernandsouthernareaofChina.RatiobetweenGERDandREis3∶1inourstudy.Age>40(OR1.01),greasyfood(OR6.56),bigappetite(OR1.99),tiredness(OR2.35),emotionalstress(OR2.22),pregnancy(OR6.80)andconstipation(OR1.65)aretheriskfactorsofGERD.【Keywords】GastroesophagealrefluxGastroesophagealrefluxdiseaseRefluxesophagitis胃食管反流病(gastroesophagealrefluxdisease,GERD)是指过多的胃、十二指肠内容物反流入食管，引起烧心、反酸、反食等，甚至有食管粘膜的病理性损害——反流性食管炎(refluxesophagitis,RE)。但GERD病人不一定均伴有RE。本症还可引起口咽、喉、气道等食管外的组织损害。关于人群中症状性胃食管反流...
