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中国人群胃食管反流病的患病率、临床谱及医疗服务利用情况:一项基于人群的研究

Prevalence, clinical spectrum and health care utilization of gastro-oesophageal reflux disease in a Chinese population: a population-based study.

作者信息

Wong W M, Lai K C, Lam K F, Hui W M, Hu W H C, Lam C L K, Xia H H X, Huang J Q, Chan C K, Lam S K, Wong B C Y

机构信息

Departments of Medicine and Statistics and Actuarial Science, University of Hong Kong, Hong Kong.

出版信息

Aliment Pharmacol Ther. 2003 Sep 15;18(6):595-604. doi: 10.1046/j.1365-2036.2003.01737.x.

Abstract

BACKGROUND

Population-based data on gastro-oesophageal reflux disease in Chinese are lacking. The prevalence, clinical spectrum and health care-seeking behaviour of subjects with gastro-oesophageal reflux disease were studied.

METHODS

Ethnic Chinese (3605) were invited to participate in a telephone survey using a validated gastro-oesophageal reflux disease questionnaire and the Hospital Anxiety and Depression Scale.

RESULTS

A total of 2209 subjects (58% female; mean age, 40.3 years) completed the interview. The annual, monthly and weekly prevalence rates of gastro-oesophageal reflux disease were 29.8%, 8.9% and 2.5%, respectively. Gastro-oesophageal reflux disease symptoms were associated with non-cardiac chest pain [odds ratio (OR), 2.3; 95% confidence interval (95% CI), 1.7-3.1], dyspepsia (OR, 1.9; 95% CI, 1.4-2.5), globus (OR, 1.8; 95% CI, 1.2-2.7), acid feeling in the stomach (OR, 5.8; 95% CI, 4.5-7.5) and the use of non-steroidal anti-inflammatory drugs (OR, 2.3; 95% CI, 1.5-3.6), but not with dysphagia, bronchitis, asthma, hoarseness and pneumonia. Patients with gastro-oesophageal reflux disease had a significantly higher anxiety and depression score and required more days off work when compared with subjects without. The frequency of heartburn (P = 0.032), female gender (P < 0.001), degree of depression (P = 0.004) and social morbidity (P < 0.001) were independent factors associated with health care-seeking behaviour.

CONCLUSION

The prevalence of gastro-oesophageal reflux disease was lower than that in Western populations, but carried a significant socio-economic burden in the studied Chinese population. The frequency of heartburn, female gender and psychosocial factors were associated with health care utilization in gastro-oesophageal reflux disease.

摘要

背景

中国缺乏基于人群的胃食管反流病数据。本研究对胃食管反流病患者的患病率、临床症状谱及就医行为进行了调查。

方法

采用经过验证的胃食管反流病问卷及医院焦虑抑郁量表,对3605名华裔进行电话调查。

结果

共有2209名受试者(58%为女性;平均年龄40.3岁)完成访谈。胃食管反流病的年患病率、月患病率和周患病率分别为29.8%、8.9%和2.5%。胃食管反流病症状与非心源性胸痛[比值比(OR),2.3;95%置信区间(95%CI),1.7 - 3.1]、消化不良(OR,1.9;95%CI,1.4 - 2.5)、咽部异物感(OR,1.8;95%CI,1.2 - 2.7)、胃部反酸感(OR,5.8;95%CI,4.5 - 7.5)及使用非甾体类抗炎药(OR,2.3;95%CI,1.5 - 3.6)相关,但与吞咽困难、支气管炎、哮喘、声音嘶哑及肺炎无关。与无胃食管反流病的受试者相比,胃食管反流病患者的焦虑和抑郁评分显著更高,且需要更多的休工天数。烧心频率(P = 0.032)、女性(P < 0.001)、抑郁程度(P = 0.004)及社会发病率(P < 0.001)是与就医行为相关的独立因素。

结论

胃食管反流病的患病率低于西方人群,但在所研究的中国人群中带来了显著的社会经济负担。烧心频率、女性及心理社会因素与胃食管反流病的医疗利用相关。

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