非糜烂性反流病和糜烂性食管炎患者心理状况及生活质量调查

目的 比较非糜烂性反流病(NERD)和糜烂性食管炎(EE)患者的反流症状、心理状况和生活质量等情况,为更好的诊治胃食管反流病提供帮助.方法 对274例胃食管反流病(GERD)患者及75例正常对照者进行问卷调查,包括一般资料、反流症状、食管外症状、精神心理状况及生活质量评价.结果 274例GERD患者中EE患者97例(35.4%),NERD患者143例(52.2%),Barrett食管患者34例(12.4%);与EE比较NERD患者中女性多见(62.2%VS 47.4%,P＜0.05).EE组与NERD组患者年龄、体质量指数(BMI)及食管外症状发病率差异无统计学意义.GERD患者的反流症状评分、焦虑抑郁评分及食管外症状发病率均明显高于正常对照者(P＜0.01),且生活质量评分低于正常对照者;与EE组比较,NERD患者反流症状、精神心理异常更明显,生活质量下降也更严重(P＜0.01).结论 与EE患者相比,NERD患者有更明显的反流症状、更突出的精神心理因素,及更严重的生活质量损害,对NERD患者应重视包括心理治疗在内的综合治疗.

Clinical survey of psychological status and quality of life with non-erosive reflux disease and erosive esophagitis

Objective To compare the reflux symptom, psychological status and quality of life between nonerosive reflux disease（NERD） and erosive esophagitis（EE） for assistance to the treatment with gastroesophageal reflux disease（GERD）. Methods 274 GERD patients and 75 healthy controls were enrolled. All subjects underwent the questionnaires, including general data, gastroesophageal reflux symptom score, extra-esophageal symptoms, evaluation of psychological status and quality of life. Results Among 274 GERD patients, 97 cases（35.4 %） were EE, 143 cases （52.2%） were NERD and 34 cases （12.4%） were Barrett esophagues. NERD patients were predominant in female compared with EE patients （62.2% vs 47.4%, P 〈0.05）. There was no significant difference between EE and NERD patients in age, BMI and extra-esophageal symptom. The anxious and depression score, gastroesophageal reflux symptom score,and the prevalence of extra-esophageal symptoms of GERD patients were much higher than those of healthy controls. The quality of life was much poorer in GERD compared with that in healthy controls. The gastroesophageal reflux symptom and psychological disorder were much more obvious in NERD patients than that of EE patients. The decline of quality of life was also significant in NERD patients compared with that of EE patients（ P〈 0.01）. Conclusion NERD patients might have more serious GERD symptom,psychological disorder and much poorer quality of life compared with EE patients. The therapy for NERD should combine with psychotherapy.