北京上海胃食管反流症状的流行病学调查【摘要】目的了解北京、上海成人胃食管反流病(GERD)和反流性食管炎(RE),在1996年7~9月调查时一年内的患病率及其相关性疾病和危险因素等。方法对两市18~70岁城乡常住人口5000例,进行整群、分层、随机抽样的问卷调查。以反酸、烧心、反食症状程度和频度的积分(Sc,最高18分)作为反流的指标,Sc≥6表明存在症状性反流(GER);再抽取一部分反流阳性病人和对照者用胃镜和24小时pH监测作精查,根据精查的正确率对普查结果校正后测算出患病率。结果(1)共4992例完成了筛查,人群中每日有烧心者占2.5%;Sc≥6者448例占8.97%,男女之比为1∶1.1;精查正确率为64%,据此推测GERD的患病率为5.77%,RE为1.92%。(2)分层分析显示,有反流症状者北京(10.19%)多于上海(7.76%),北京的男性病人、体力劳动者及农村的患病率均高于上海;此外,40岁以上的患病率增多。(3)反流组伴发口咽喉病患、哮喘和支气管炎的频率比非病人人群明显为高。结论调查结果显示,GERD为多发病,但我国南北方的患病率有差别。GERD和RE的比值为3∶1。年龄(OR1.01)、饱食(OR1.99)、油腻食物(OR6.56)、劳累(OR2.35)、精神情绪(OR2.22)、妊娠(OR6.80)、排便困难(OR1.65)等因素和反流有密切关系。【关键词】反流胃食管反流病反流性食管炎AnepidemiologicstudyonsymptomaticGERinBeijingandShanghaiPANGuozong,XUGuoming,GUOHuiping,etal.PekingUnionMedicalCollegeHospital,Beijing100730,andChanghaiHospital,TheSecondMilitaryMedicalUniversity,Shanghai200433【Abstract】ObjectiveToexploretheoneyear-pointprevalences(Jul-Sep,1996)ofsymptomaticgastroesophagealreflux(GER),gastroesophagealrefluxdisease(GERD)andrefluxesophagitis(RE)amongadultpopulationinBeijingandShanghaiandtoidentifytheriskfactorsofGERD.Methods5000residencesofthetwocities,agebetween18-70werestudiedthroughquestionaire.Studywasdonebyclusteringsamplingfromcity,surburbanandruralareasusingsimplerandomsampling.Symptomscores(Sc)oftheintensityandfrequencyofheartburn,acidrefluxandregurgitationwithinoneyearatthetimeofstudyweretakenasindicesofacidreflux(highestSc=18)andSc≥6indicatedthepresenceofsymptomaticGER.AcasecontrolstudywasalsoperformedinsomesubjectsfromthesurveytoconfirmthediagnosisofGERDandREusinggastroscopyand24hpHmonitor...