Ruigómez Ana, García Rodríguez Luis Alberto, Wallander Mari-Ann, Johansson Saga, Dent John
Centro Español de Investigación Farmacoepidemiológica (CEIFE), Madrid, Spain.
Curr Med Res Opin. 2006 Sep;22(9):1661-8. doi: 10.1185/030079906X120986.
It is unclear how gastro-oesophageal reflux disease (GORD) is diagnosed in primary care. The aim of this study is to compare patients given a diagnosis of GORD with those diagnosed with heartburn.
Data from the UK General Practice Research Database were extracted for patients newly diagnosed with heartburn (n = 1841) or GORD (n = 5318) in 1996.
Patient characteristics, morbidity, healthcare use and prescribed treatments were compared using unconditional logistic regression analysis.
GORD was diagnosed more frequently than heartburn (3.2 vs. 1.1 per 1000 patient-years). A diagnosis of GORD was less likely among females (odds ratio (OR): 0.8; confidence interval (CI): 0.7-0.9), smokers (OR: 0.8; CI: 0.7-0.9) and patients who consulted their physician frequently (OR: 0.8; CI: 0.7-0.9). There was a wide distribution in the ratio of GORD-to-heartburn diagnoses between primary care practices (mean 2.9; range 0-infinity). GORD patients were more likely to receive proton pump inhibitors (OR: 2.9; CI: 2.6-3.4), but 24% of GORD patients and 40% of heartburn patients received no acid-suppressive treatment in the month after diagnosis.
Several factors influenced the diagnosis of gastro-oesophageal reflux symptoms by primary care physicians. Further research is needed to aid the diagnosis of GORD in primary care.
目前尚不清楚初级保健中如何诊断胃食管反流病（GORD）。本研究旨在比较诊断为GORD的患者与诊断为烧心的患者。
从英国全科医学研究数据库中提取1996年新诊断为烧心（n = 1841）或GORD（n = 5318）的患者数据。
使用无条件逻辑回归分析比较患者特征、发病率、医疗保健使用情况和处方治疗。
GORD的诊断频率高于烧心（每1000患者年分别为3.2例和1.1例）。女性（优势比（OR）：0.8；置信区间（CI）：0.7 - 0.9）、吸烟者（OR：0.8；CI：0.7 - 0.9）和经常咨询医生的患者（OR：0.8；CI：0.7 - 0.9）中诊断为GORD的可能性较小。初级保健机构之间GORD与烧心诊断的比例分布广泛（平均2.9；范围0至无穷大）。GORD患者更有可能接受质子泵抑制剂（OR：2.9；CI：2.6 - 3.4），但24%的GORD患者和40%的烧心患者在诊断后的一个月内未接受抑酸治疗。
有几个因素影响了初级保健医生对胃食管反流症状的诊断。需要进一步研究以协助初级保健中GORD的诊断。
