西班牙非典型症状的患病率及其与胃食管反流典型症状的关联。

Prevalence of atypical symptoms and their association with typical symptoms of gastroesophageal reflux in Spain.

作者信息

Rey Enrique, Elola-Olaso Cristina Moreno, Rodríguez-Artalejo Fernando, Locke G Richard, Díaz-Rubio Manuel

机构信息

Digestive Disease Service, Hospital Clinico San Carlos, Complutense University, Madrid, Spain.

出版信息

Eur J Gastroenterol Hepatol. 2006 Sep;18(9):969-75. doi: 10.1097/01.meg.0000230081.53298.03.

DOI:10.1097/01.meg.0000230081.53298.03

PMID:16894310

Abstract

BACKGROUND

The association between typical and atypical symptoms of gastroesophageal reflux (GER) has received little attention in population-based studies. This study therefore sought to examine the prevalence of atypical symptoms, and their association with typical GER symptoms in Spain.

METHODS

A telephone survey using a validated questionnaire was conducted in 2002 on 2500 subjects aged 40-79 years, randomly selected from the general population of Spain. The questionnaire included items on typical GER symptoms (heartburn and acid regurgitation) and several atypical symptoms (chest pain, dysphagia, belching, dyspepsia, globus, hoarseness, hiccups, chronic cough and asthma). The association between typical GER symptoms and each atypical symptom was summarized using odds ratios obtained from logistic regression.

RESULTS

The response rate was 71.2%. A total of 60.8% (95% confidence interval 59.0-62.8%) of subjects reported suffering from at least one atypical symptom during the year preceding the interview. The prevalence rates varied from 26.7% for hoarseness to 6.6% for asthma. The prevalence of atypical symptoms was higher among the 791 subjects with typical GER symptoms than among the 1709 subjects reporting no typical GER symptoms (79.6 versus 52.2%). It was also higher among those reporting frequent typical GER symptoms compared with those reporting occasional symptoms (87.8 versus 58%). After adjustment for age, sex, coffee, alcohol and tobacco consumption, and psychosomatic symptoms, an association (P<0.05) was observed between typical symptoms and the respective atypical symptoms, with odds ratios ranging from 1.4 for asthma to 4.6 for belching. After additional adjustment for the remaining atypical symptoms, chest pain, dysphagia, dyspepsia, belching and globus were each independently associated with typical reflux symptoms.

CONCLUSION

The prevalence of atypical GER symptoms is extremely high. There is an association between typical and atypical GER symptoms, particularly chest pain, dysphagia, dyspepsia, belching and globus.

摘要

背景

在基于人群的研究中，胃食管反流（GER）典型症状与非典型症状之间的关联很少受到关注。因此，本研究旨在调查西班牙非典型症状的患病率及其与GER典型症状的关联。

方法

2002年，使用经过验证的问卷对从西班牙普通人群中随机抽取的2500名40 - 79岁的受试者进行了电话调查。问卷包括关于GER典型症状（烧心和反酸）以及几种非典型症状（胸痛、吞咽困难、嗳气、消化不良、咽部异物感、声音嘶哑、打嗝、慢性咳嗽和哮喘）的项目。使用从逻辑回归获得的比值比总结典型GER症状与每种非典型症状之间的关联。

结果

应答率为71.2%。共有60.8%（95%置信区间59.0 - 62.8%）的受试者报告在访谈前一年中至少出现过一种非典型症状。患病率从声音嘶哑的26.7%到哮喘的6.6%不等。有典型GER症状的791名受试者中非典型症状的患病率高于1709名未报告典型GER症状的受试者（79.6%对52.2%）。与偶尔出现典型GER症状的受试者相比，经常出现典型GER症状的受试者中非典型症状的患病率也更高（87.8%对58%）。在对年龄、性别、咖啡、酒精和烟草消费以及心身症状进行调整后，观察到典型症状与各自的非典型症状之间存在关联（P<0.05），比值比范围从哮喘的1.4到嗳气的4.6。在对其余非典型症状进行额外调整后发现，胸痛、吞咽困难、消化不良、嗳气和咽部异物感均各自独立地与典型反流症状相关。