A comparison of the clinical, demographic and psychiatric profiles among patients with erosive and non-erosive reflux disease in a multi-ethnic Asian country
A comparison of the clinical, demographic and psychiatric profiles among patients with erosive and non-erosive reflux disease in a multi-ethnic Asian country
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DOI：
10.3748/wjg.v11.i23.3558
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发表时间：
2005-06-21
影响因子：
4.3
通讯作者：
Tan, Jessica
中科院分区：
文献类型：
--
作者：
Ang, Tiing-Leong;Fock, Kwong-Ming;Tan, Jessica
目的：研究胃食道反流病(GERD)的临床特征，比较糜烂型(ERD)和非糜烂型(NERD)在临床、人口学和精神病学方面的差异。方法：对有反流症状的患者进行胃镜检查后分为NERD和ERD(LA分级)。包括以消化不良为表现的ERD患者。排除内窥镜检查前服用质子泵抑制剂(PPI)或H-2受体拮抗剂的患者。结果：在筛选的690例患者中，533例符合分析条件(男女比例：3：2；华人：75.4%；马来人：9.8%；印度人：14.8%)。临床表现：N组40.5%，A组46%，B组9.2%，C组2.1%，D组0.6%，Barrett‘s食道1.7%。与NERD患者相比，ERD患者年龄更大(45比39.4岁)，男性更多(64.4%比53.7%)，有吸烟倾向(19.6%比9.7%)，较少有轻微精神障碍(26.4比46.7%)，更有可能对PPI有反应(79.7比66.8%)。体重指数也有升高的趋势(24.5比23.5)。种族、饮酒和幽门螺杆菌感染状况均无统计学意义。经多因素分析，年龄和轻度精神疾病的发生率仍有显著差异。结论：大多数具有典型GERD症状的患者都有NERD或轻度糜烂性反流病。与糜烂性反流病患者相比，NERD患者更年轻，轻微精神疾病的患病率更高。(C)2005年WJG Press和Elsevier Inc.保留所有权利。
AIM: To examine the clinical spectrum of gastroesophageal reflux disease (GERD) and compare erosive (ERD) with non-erosive (NERD) in terms of clinical, demographic and psychiatric profiles.METHODS: Patients with reflux symptoms were enrolled and stratified to NERD and ERD after endoscopy (LA classification). Patients with ERD presenting with dyspepsia were included. Patients on proton pump inhibitors (PPI) or H-2 receptor antagonists before endoscopy were excluded. Demographic data, Helicobacter pylori (H pylori) status and presence of minor psychiatric morbidity (based on General Health Questionnaire-28) were analyzed.RESULTS: Among 690 patients screened, 533 were eligible for analysis (male to female ratio: 3:2; Chinese: 75.4%; Malay: 9.8%; Indian: 14.8%). Clinical spectrum of GERD: N: 40.5%; A: 46%; B: 9.2%; C: 2.1%; D: 0.6%; Barrett's esophagus: 1.7%. Compared to patients with NERD, patients with ERD were significantly older (45 vs 39.4 years), more likely to be male (64.4% vs 53.7%), tended to smoke (19.6% vs 9.7%), less likely to have minor psychiatric morbidity (26.4 vs 46.7%) and were more likely to respond to PPI (79.7 vs 66.8%). There was also a trend towards a higher BMI (24.5 vs 23.5). Race, alcohol consumption and H pylori status were not significant. On multivariate analysis, age and presence of minor psychiatric morbidity remained with significant differences.CONCLUSION: The majority of patients who have typical symptoms of GERD have NERD or mild erosive reflux disease. Compared to patients with erosive reflux disease, patients with NERD were younger and had a higher prevalence of minor psychiatric morbidity. (C) 2005 The WJG Press and Elsevier Inc. All rights reserved.