胃食管反流病的流行病学更新:系统评价。
Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review.
机构信息
Section of Gastroenterology and Hepatology, Houston Veterans Affairs Medical Center (152), , Houston, Texas, USA.
出版信息
Gut. 2014 Jun;63(6):871-80. doi: 10.1136/gutjnl-2012-304269. Epub 2013 Jul 13.
OBJECTIVE
To update the findings of the 2005 systematic review of population-based studies assessing the epidemiology of gastro-oesophageal reflux disease (GERD).
DESIGN
PubMed and Embase were screened for new references using the original search strings. Studies were required to be population-based, to include ≥ 200 individuals, to have response rates ≥ 50% and recall periods <12 months. GERD was defined as heartburn and/or regurgitation on at least 1 day a week, or according to the Montreal definition, or diagnosed by a clinician. Temporal and geographic trends in disease prevalence were examined using a Poisson regression model.
RESULTS
16 studies of GERD epidemiology published since the original review were found to be suitable for inclusion (15 reporting prevalence and one reporting incidence), and were added to the 13 prevalence and two incidence studies found previously. The range of GERD prevalence estimates was 18.1%-27.8% in North America, 8.8%-25.9% in Europe, 2.5%-7.8% in East Asia, 8.7%-33.1% in the Middle East, 11.6% in Australia and 23.0% in South America. Incidence per 1000 person-years was approximately 5 in the overall UK and US populations, and 0.84 in paediatric patients aged 1-17 years in the UK. Evidence suggests an increase in GERD prevalence since 1995 (p<0.0001), particularly in North America and East Asia.
CONCLUSIONS
GERD is prevalent worldwide, and disease burden may be increasing. Prevalence estimates show considerable geographic variation, but only East Asia shows estimates consistently lower than 10%.
目的
更新 2005 年系统评价中基于人群的研究对胃食管反流病(GERD)流行病学评估结果。
设计
使用原始检索词在 PubMed 和 Embase 上筛选新的参考文献。研究必须基于人群,包含≥200 名个体,应答率≥50%,回忆期<12 个月。GERD 根据每周至少 1 天出现烧心和/或反流定义,或根据蒙特利尔定义定义,或由临床医生诊断。使用泊松回归模型检查疾病流行率的时间和地理趋势。
结果
发现 16 项 GERD 流行病学研究符合纳入标准(15 项报告患病率,1 项报告发病率),并与之前发现的 13 项患病率研究和 2 项发病率研究一起纳入。北美 GERD 患病率估计值范围为 18.1%-27.8%,欧洲为 8.8%-25.9%,东亚为 2.5%-7.8%,中东为 8.7%-33.1%,澳大利亚为 11.6%,南美洲为 23.0%。英国和美国总人口中每 1000 人年的发病率约为 5,英国 1-17 岁儿科患者为 0.84。有证据表明自 1995 年以来 GERD 患病率增加(p<0.0001),尤其是在北美和东亚。
结论
GERD 在全球普遍存在,疾病负担可能在增加。患病率估计值存在显著的地理差异,但只有东亚的估计值始终低于 10%。