不同亚型难治性胃食管反流病患者心理状态分析

目的 分析不同亚型难治性胃食管反流病（rGERD）患者的心理状态。方法 选择2017年1月至2019年10月在安徽医科大学附属省立医院消化内科门诊就诊的182例rGERD患者，均行24 h pH-阻抗监测，根据临床表现与病理学检查结果分为反流性食管炎组（RE组，n=54）、非糜烂性反流病组（NERD组，n=108）和Barrett食管组（BE组，n=20），利用汉密尔顿焦虑量表（HAMA）与汉密尔顿抑郁量表（HAMD）评估患者的心理状态，应用GERD专用生活质量（GERD-HRQL）量表对3组患者的生活质量进行评价。结果 3组患者HAMA、HAMD评分的差异有统计学意义（P<0.05），且NERD组患者HAMA和HAMD评分高于RE组，差异有统计学意义（P<0.05）。NERD组患者弱酸反流发生率高于RE组、BE组，差异均有统计学意义（P<0.0167）。结论 NERD患者比RE、BE患者更易发生弱酸反流，更易出现焦虑、抑郁症状，可能是rGERD的发病机制之一。

Analysis of mental state of refractory gastroesophageal reflux patients with different subtypes

Objective To explore the psychological characteristicsof rGERD patients with different subtypes. Methods Clinical data of 182 rGERD patients in department of gastricenterology of Affiliated Provincial Hospital of Anhui Medical Universityfrom January 2017 to October 2019 were collected. 24h-pH monitoring were performed in all patients, according to clinical manifestations and pathological examination results, divided into reflux esophagitis (RE,n=54), non-erosive reflux disease (NERD,n=108) and Barrett esophagus group (BE,n=20). Their psychological characteristics by HAMA and HAMD scores and their quality of life by GERD-HRQL scores were evaluated. Results There was no significant difference among the three groups in gender, age, BMI, the courses of disease and GERD-HRQL(P>0.05).There were significant differences among the three groups of patients'' HAMA and HAMD scores (P<0.05). NERD group had higher HAMA and HAMD scores than RE group patients (P<0.05).NERD group had the highest incidence of weak acid reflux, which was significantly different from RE group and BE group (P<0.0167). Conclusion NERD patients are more likely to have weak acid reflux than RE and BE patients, and are more likely to be accompanied by anxiety and depression, which may be one of the pathogenesis of rGERD.