胃食管反流病相关危险因素分析

胃食管反流病（GERD）的发病与多种因素有关，我国以及亚洲地区患病率呈上升趋势。目的：分析GERD相关危险因素。方法：纳入2010年5～10月新疆医科大学第一附属医院有典型胃食管反流症状、反流性疾病问卷（RDQ）评分〉12或内镜检查发现食管黏膜破损者作为病例组，以同期非GERD患者和健康体检者作为对照组，采用问卷调查的方式采集人口统计学资料、生活方式、饮食习惯等信息，对19个可能与GERD有关的变量行单因素分析，有统计学意义者进一步行多因素条件logistic回归。结果：病例组和对照组例数分别为100例和120例。单因素分析显示年龄、体质指数（BMI）、浓茶、进食过饱、辛辣饮食、高盐饮食、食管裂孔疝（HH）、幽门螺杆菌（Hpylon）感染、非甾体消炎药（NSAIDs）、民族、便秘11个变量与GERD相关（P〈0．05）。多因素条件logistic回归分析显示HH（OR：3．614，95％CI：1．188～10．993，P=0．024）、辛辣饮食（OR：5．469，95％CI：2．570—11．640，P=0．000）、便秘（OR：3．760，95％CI：1．592～8．884，P=0．003）、中老年（OR：5．229，95％CI：1．090～8．587，P=0．005；OR：2．275，95％CI：1．004～6．667，P=0．004）为GERD发病的危险因素。结论：认识和避免GERD发病相关危险因素，养成良好的生活、饮食习惯以及治疗HH将对GERD的预防产生积极影响。

Analysis of Risk Factors for Gastroesophageal Reflux Disease

Background： Gastroesophageal reflux disease （GERD） is considered to be associated with multiple factors, and its prevalence is increasing in China and Asian countries. Aims： To investigate the risk factors for GERD. Methods： Patients diagnosed as GERD by the presence of typical GERD symptoms （reflux disease questionnaire score 〉 12 ） or by the presence of erosive esophagitis on endoscopy from May 2010 to Oct. 2010 at the First Affiliated Hospital of Xinjiang Medical University were enrolled. Non-GERD patients and healthy subjects selected in the same time period were served as controls. A questionnaire consisting of demographic data, lifestyle and dietary characteristics was completed for each subject. Nineteen suspected variables were screened by univariate analysis and those with statistical significance were further analyzed by multivariate conditional logistic regression. Results： One hundred GERD patients and 120 controls were enrolled in this case-control study. Eleven variables, including age, body mass index （ BMI）, strong tea, over eating, spicy food, high salt diet, hiatus hernia （HH）, Helicobacter pylori （H. pylori） infection, non-steroidal antiinflammatory drugs （ NSAIDs）, nationality, and constipation were found to be correlated with GERD by univariate analysis （ P 〈 0.05 ）, and multivariate conditional logistic regression analysis demonstrated that HH （OR： 3. 614, 95% CI： 1. 188-10. 993, P = 0.024）, spicy food （OR： 5.469, 95% CI： 2.570-11. 640, P =0. 000）, constipation （OR： 3. 760, 95% CI： 1. 592- 8. 884, P = 0.003）, middle age （ OR ： 3. 229, 95% CI ： 1. 090-8. 587, P = 0. 005） and old age （OR ： 2. 275, 95% CI ： 1. 004-6. 667, P = 0. 004 ） were risk factors for GERD. Conclusions ： Understanding and avoiding GERD-related risk factors, keeping healthy lifestyle and eating habits, and curing of HH might contribute to the prevention of GERD.