北京市海淀区社区居民胃食管反流病的流行病学调查

目的 了解北京市海淀区胃食管反流病(GERD)及其相关症状的分布情况,探讨可能的危险因素,并分析其与既往疾病的相关关系.方法 2008年6-9月,采用多阶段抽样法,对海淀区18～80岁的2615名常住居民进行问卷调查,内容包括基本信息、伴发疾病及反流性疾病问卷.结果 海淀区人群GERD的患病率为8.4%(220/2615),单纯胃灼热、单纯反流、两个症状均有的现患率分别为1.0%(25/2615),6.2%(163/2615)和1.2%(32/2615).多因素分析发现,GERD的可能危险因素有生活在农村(OR=2.237,95%CI:1.422～3.517)、女性(OR=1.456,95%CI:1.085～1.955)、高学历(OR=1.242,95%CI:1.001～1.542)、工作生活压力大(OR=1.277,95%CI:1.089～1.497)、精神状态差(OR=1.320,95%CI:1.046～1.665)和有胃肠病家族史(OR=1.594,95%CI:1.075～2.365);胃灼热症状的危险因素有居住在农村(OR=2.481,95%CI:1.278～4.818)、女性(OR=1.747,95%CI:0.902～3.386)、饮酒(OR=1.838,95%CI:0.916～3.690)、不运动(OR=2.091,95%CI:1.131～3.867)和精神状态差(OR=1.657,95%CI:1.123～2.446);反流症状的可能危险因素有生活在农村(OR=2.171,95%CI:1.326～3.556)、女性(OR=1.505,95%CI:1.102～2.056)、高学历(OR=1.347,95%CI:1.063～1.706)、工作生活压力大(OR=1.317,95%CI:1.113～1.558)、精神状态差(OR=1.266,95%CI:0.992～1.616)和有胃肠病家族史(OR=1.739,95%CI:1.163～2.600).GERD、胃灼热和反流症状与既往病史如焦虑症、抑郁症、消化性溃疡、胃炎、炎症性肠病、肾病有较强的关联.结论 GERD及其相关症状在该地区有一定程度的流行,它与不健康的生活方式、精神心理问题等相关,需要在社区开展有效的干预措施.

A community-based epidemiologic study on gastroesophageal reflux disease in Haidian district of Beijing

Objective To explore the prevalence of gastroesophageal reflux disease(GERD)and its symptoms in Haidian district of Beijing.identify its associated risk factors and analyze the relations between GERD and history of other diseases.Methotis 2615 residents of 18-80 years old were selected to participate in the study by multi-stage sampling from Haidian district from June and September in 2008.Questionnaires were distributed to obtain the information on demographic characteristics,diseases history and the reflux disease questionnaire(RD9).Results The prevalence of GERD in the population was 8.4%(220/2615).and the prevalence of heartburn,reflux,both heartburn and reflux were 1.0% (25/2615),6.2%(163/2615)and 1.2%(32/2615).respectively.Multi-factor analysis showed rural area (OR=2.237,95%CI:1.422-3.517),female(OR=1.456,95% CI:1.085-1.955),high education (OR=1.242,95%CI:1.001-1.542),pressure (OR=1.277,95% CI:1.089-1.497),bad emotional Status (OR=1.320,95% CI:1.046-1.665),and family history of gastrointestinal disorders (OR=1.594,95% CI:1.075-2.365) were significantly associated with GERD.Rural area(OR=2.481,95%CI:1.278-4.818),female(OR=1.747,95% CI:0.902-3.386),drinking(OR=1.838,95%CI:0.916-3. 690) ,no exercise ( OR = 2. 091 ; 95% CI: 1. 131 - 3. 867 ) and bad emotional status ( OR = 1. 657,95%CI: 1. 123 - 2. 446 ) were significant risk factors for heartburn. Rural area ( OR = 2. 171,95% CI:1. 326 -3. 556) ,female ( OR = 1. 505,95% CI: 1. 102 - 2. 056 ), high education ( OR = 1. 347,95% CI:1. 063 - 1. 706 ), pressure ( OR = 1. 317,95% CI: 1. 113 - 1. 558 ), bad emotional status ( OR = 1. 266,95% CI:0. 992 - 1. 616 ), and family history of gastrointestinal disorders ( OR = 1. 739,95% CI: 1. 163 -2. 600) were significantly associated with reflux symptom. History of diseases such as inflammatory bowel disease, anxiety, depression, peptic ulcer, gastritis, and renal diseases were found to be significantly related to GERD and its symptoms. Conclusion This area has epidemic of GERD, which was related to mental problems and unhealthy life style, and should be paid more attention by conducting effective community-based interventions.