【摘要】 背景:胃食管反流病(GERD)包括非糜烂性反流病(NERD)、反流性食管炎(RE)和Barrett食管(BE),其发病机制可能有所不同。目的:分析比较NERD和RE患者的人口学特征和临床特点,为探讨其发病机制和有效治疗提供依据。方法:对连续入组的278例GERD患者进行问卷调查,内容包括一般人口学资料、胃食管反流以及相关症状评分、食管外症状、重叠症状、生活质量评价和精神心理状态评价。结果:NERD和RE分别占GERD的60.8%和37.1%;与RE组相比,NERD患者以女性多见(P<0.05),平均年龄较轻(P<0.05)。胃食管反流症状评分在两组患者间无显著差异,但RE组烧心频率较NERD组高(P<0.05),而NERD组胸骨后疼痛更突出,反食症状较轻。两组患者的食管外症状、重叠症状发生率无显著差异。NERD组患者生活质量下降更明显。NERD组患者合并精神心理异常的比例显著高于RE组(P<0.05),且抑郁评分高。结论:本组资料中大部分GERD患者为NERD,NERD和RE的反流以及相关症状谱无显著差异,但NERD患者常合并精神心理异常、生活质量下降,提示精神心理因素在NERD的发病中可能起重要作用。更多还原

【Abstract】 Background: Gastroesophageal reflux disease (GERD) consists of non-erosive reflux disease (NERD), reflux esophagitis (RE) and Barrett’s esophagus (BE), and the pathogenesis of these three entities may not be the same. Aims: To analyze and compare the demographic characteristics and clinical features of patients with NERD and RE, so as to appraise their pathogenesis and effective treatment. Methods: Two hundred and seventy-eight consecutive patients with GERD were enrolled and asked to complete the questionnaires, which included demographic data, gastroesophageal reflux and reflux-related symptoms score, extra-esophageal symptoms, overlapping symptoms and the evaluation of quality of life and psychological status. Results: Among the 278 patients, 60.8% were NERD and 37.1% were RE. Compared with patients with RE, NERD patients were significantly younger, predominant in female (P<0.05). There was no significant difference between NERD and RE groups in reflux symptoms score, however, retrosternal pain was more severe in NERD patients than in RE patients (P<0.05), whereas heartburn and regurgitation were milder. The extra-esophageal symptoms and overlapping symptoms were similar in both groups. The decline of quality of life was more obvious in NERD patients than in RE patients, and the proportion of patients with abnormal psychological status in NERD group was significantly higher than in RE group (P<0.05) and the depression score was higher. Conclusions: In this clinical survey, majority of GERD patients were NERD and there was no significant difference in reflux-related symptom spectrum between NERD and RE. NERD patients were more likely co-morbid with psychological disorders and having poorer quality of life. These results suggest that psychological factors may play an important role in the pathogenesis of NERD.更多还原