老年胃食管反流病患者临床症状、心理状况和生活质量调查

背景:近年来,胃食管反流病(GERD)的患病率呈增高趋势,且其患病率随年龄的增长而增加。目的:分析GERD患者,尤其是老年GERD患者的胃食管反流症状、食管外症状、精神心理和生活质量状况,为GERD的诊治提供依据。方法:于2007年1月～2009年7月连续纳入GERD患者296例(老年组160例,非老年组136例),同期纳入正常对照者60例。以反流性疾病问卷(RDQ)和食管外症状调查问卷评价患者的胃食管反流症状和食管外症状,Zung焦虑自评量表(SAS)和Zung抑郁自评量表(SDS)调查患者的精神心理状况,SF-36健康凋查量表评价患者的生活质量情况。结果:GERD患者的胃食管反流症状和食管外症状较正常对照组更常见且更严重,SAS评分和SDS评分明显高于正常对照组,SF-36评分明显低于正常对照组,差异均有统计学意义(P0.05)。GERD组老年患者与非老年患者间的胃食管反流症状差异无统计学意义;老年GERD患者的食管外症状发生率较高,SAS和SDS评分明显高于非老年患者,SF-36评分明显低于非老年患者,差异均有统计学意义(P0.05)。结论:GERD患者常伴有精神心理异常和生活质量下降。老年人更易罹患GERD,老年GERD患者食管外症状较常见,心理健康水平更易受到影响,生活质量下降更为明显。

Clinical Survey of Symptoms,Psychological Status and Quality of Life in Elderly Patients with Gastroesophageal Reflux Disease

Background： The prevalence of gastroesophageal reflux disease （GERD） has been rising in recent years and increases with age. Aims： To analyze the gastroesophageal reflux symptoms, extra-esophageal symptoms, psychological status and quality of life （QOL） of GERD patients especially the elderly patients, so as to provide evidence for the diagnosis and treatment of GERD. Methods： Two hundred and ninety-six consecutive GERD patients （elderly group, n=160; non-elderly group, n=136） and 60 controls, from January 2007 to July 2009, were enrolled in this study. All subjects completed questionnaires on gastroesophageal reflux symptoms （reflux disease questionnaire, RDQ）, extra-esophageal symptoms, psychological status （self-rating anxiety scale, SAS; self-rating depression scale, SDS） and QOL （short form 36, SF-36）. Results： The gastroesophageal reflux symptoms and extra-esophageal symptoms of GERD patients were more common and severe than those of controls （P〈0.05）. Scores of SAS and SDS were significantly higher in GERD＇patients than those in controls, and score of SF-36 was much lower in GERD patients （P〈0.05）. There was no significant difference of gastroesophageal reflux symptoms between elderly and non-elderly GERD patients. Prevalence of extra-esophageal symptoms was much higher in elderly GERD patients than in non-elderly patients （P〈0.05）. Scores of SAS and SDS were higher in elderly patients than in non-elderly patients, and score of SF-36 was lower in elderly patients （P〈0.05）. Conclusions： GERD patients are more likely to have mental illnesses and impairment of QOL. Elderly people have high prevalence of GERD, and they are more likely to have extra-esophageal symptoms, mental illnesses and poor QOL.