Mishima Ikuyo, Adachi Kyoichi, Arima Noriyuki, Amano Kazutoshi, Takashima Toshiharu, Moritani Makoto, Furuta Kenji, Kinoshita Yoshikazu
Department of Internal Medicine, Masuda Medical Association Hospital, Masuda, and Department of Gastroenterology and Hepatology, Shimane University, School of Medicine, Japan.
Scand J Gastroenterol. 2005 Sep;40(9):1005-9. doi: 10.1080/00365520510023260.
The frequency of gastroesophageal reflux disease (GERD) has not been fully investigated in the Asian population. The aim of this study was to investigate the prevalence of GERD, endoscopy-negative GERD (NERD), and erosive GERD in Japan, and the factors influencing disease prevalence.
A total of 2760 subjects (mean age 50.4 years, range 24-84 years) were prospectively enrolled in this multicenter study. GERD symptoms were assessed with the Japanese version of the Carlsson-Dent self-administered questionnaire (QUEST) and upper gastrointestinal endoscopy was performed on all study participants.
A total of 495 (17.9%) individuals were diagnosed with GERD by the presence of erosive esophagitis at endoscopy and/or by the presence of GERD symptoms. Erosive esophagitis was diagnosed endoscopically in 195 (7.1%), and symptomatic GERD was diagnosed in 351 (12.7%) based on a QUEST score of over 6. Of these 351 subjects, 300 (10.9%) were considered to have NERD. Male gender, hiatal hernia, and mild gastric mucosal atrophy were significant positive predictive factors of erosive esophagitis by multiple regression analysis. Hiatal hernia ws the only significant predictor of GERD symptoms. Traditional Japanese foods, such as sweet cakes and rice cake, frequently exacerbated GERD symptoms.
The prevalence of GERD in the Japanese was 17.9% and the prevalence rates of NERD and erosive esophagitis were 10.9% and 8.6%, respectively. The majority of symptomatic patients did not have endoscopically proven esophagitis. Hiatal hernia is the only important predictor of the presence of GERD symptoms.
在亚洲人群中，胃食管反流病（GERD）的发病率尚未得到充分研究。本研究旨在调查日本GERD、内镜阴性GERD（NERD）和糜烂性GERD的患病率，以及影响疾病患病率的因素。
本多中心研究前瞻性纳入了2760名受试者（平均年龄50.4岁，范围24 - 84岁）。采用日本版卡尔森 - 登特自填问卷（QUEST）评估GERD症状，并对所有研究参与者进行上消化道内镜检查。
共有495名（17.9%）个体通过内镜检查发现糜烂性食管炎和/或存在GERD症状而被诊断为GERD。内镜诊断糜烂性食管炎195例（7.1%），根据QUEST评分超过6分诊断有症状性GERD 351例（12.7%）。在这351名受试者中，300例（10.9%）被认为患有NERD。多元回归分析显示，男性、食管裂孔疝和轻度胃黏膜萎缩是糜烂性食管炎的显著阳性预测因素。食管裂孔疝是GERD症状的唯一显著预测因素。传统日本食物，如甜蛋糕和年糕，经常会加重GERD症状。
日本人中GERD的患病率为17.9%，NERD和糜烂性食管炎的患病率分别为10.9%和8.6%。大多数有症状的患者内镜检查未证实有食管炎。食管裂孔疝是GERD症状存在的唯一重要预测因素。
