Johannessen Rune, Petersen Hermod, Olberg Petter, Johnsen Gjermund, Fjøsne Ulf, Kleveland Per Martin
Department of Cancer Research and Molecular Medicine, Unit for Gastroenterology, Norwegian University of Science and Technology, Trondheim, Norway.
Scand J Gastroenterol. 2012 Jul;47(7):762-9. doi: 10.3109/00365521.2012.683041. Epub 2012 May 10.
Anti-reflux treatment studies have not succeeded in proving a causal relationship between gastroesophageal reflux disease (GERD), airway symptoms and sleeping difficulties. In a recent follow-up study we showed that patients operated for GERD have significantly less heartburn/acid regurgitation symptoms than matched non-operated patients. These two groups probably had different degrees of reflux over a long period of time. It is thus hypothesized that operated patients would report less airway symptoms and sleeping difficulties than comparable non-operated patients. A new follow-up study of the same patients was therefore conducted.
A total of 179 patients operated for GERD and 179 matched non-operated patients with confirmed GERD were sent the Reflux, Airway & Sleep Questionnaire (RASQ), which is a new, validated questionnaire dealing with heartburn/acid regurgitation, airway symptoms, and sleeping difficulties. Answers are given on a 7-point Likert scale and the assessment period is 1 year.
Response rates were 68% in both groups. Operated patients reported significantly less reflux symptoms than non-operated patients (p < 0.001). Patients in the surgery group also reported less symptoms in two subscales of the RASQ dealing with airway symptoms: Laryngopharyngitis (p = 0.04) and Bronchitis (p = 0.01). There was a tendency toward less sleeplessness in operated patients, but this was not statistically significant. Snoring was less bothersome in operated patients (p = 0.02).
Patients operated for GERD have less heartburn/acid regurgitation symptoms and less airway symptoms than non-operated patients. The findings lend support to the hypothesis of a causal relationship between gastroesophageal reflux, airway symptoms, and sleeping difficulties.
抗反流治疗研究未能成功证明胃食管反流病（GERD）、气道症状和睡眠困难之间存在因果关系。在最近的一项随访研究中，我们发现接受GERD手术的患者烧心/反酸症状明显少于匹配的未手术患者。这两组患者可能在很长一段时间内有不同程度的反流。因此，我们假设手术患者报告的气道症状和睡眠困难比类似的未手术患者少。因此，我们对同一批患者进行了一项新的随访研究。
向总共179例接受GERD手术的患者和179例匹配的确诊GERD未手术患者发送了反流、气道与睡眠问卷（RASQ），这是一份新的、经过验证的问卷，涉及烧心/反酸、气道症状和睡眠困难。答案采用7分李克特量表给出，评估期为1年。
两组的回复率均为68%。手术患者报告的反流症状明显少于未手术患者（p<0.001）。手术组患者在RASQ中涉及气道症状的两个子量表中报告的症状也较少：喉咽炎（p = 0.04）和支气管炎（p = 0.01）。手术患者失眠倾向较小，但无统计学意义。手术患者的打鼾困扰较小（p = 0.02）。
接受GERD手术的患者烧心/反酸症状和气道症状比未手术患者少。这些发现支持了胃食管反流、气道症状和睡眠困难之间存在因果关系的假设。
