Tomita Toshihiko, Yasuda Toshinari, Oka Hideo, Terao Shuichi, Arai Eitastu, Oshima Tadayuki, Fukui Hirokazu, Hori Kazutoshi, Watari Jiro, Miwa Hiroto
Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
J Gastroenterol Hepatol. 2015 Mar;30 Suppl 1:19-24. doi: 10.1111/jgh.12745.
Asymptomatic reflux esophagitis (RE) is simply regarded as RE without the typical reflux symptoms, but it is unknown whether patients with asymptomatic RE have atypical symptoms. The aim of this study was to examine the clinical characteristics and health-related quality of life (HRQOL) of patients with asymptomatic RE.
Consecutive patients with RE were enrolled during January 2010 to August 2012, and of them, 41 who had taken acid-suppressing drugs were excluded, leaving 280 patients as the study group. The patients' symptoms were evaluated using a self-completed questionnaire (modified Frequency Scale for the Symptoms of gastroesophageal reflux disease [FSSG]), as well as an HRQOL questionnaire (SF-8). We defined the typical symptoms of RE as heartburn and regurgitation. Asymptomatic RE was defined if the total symptom score was 0 or the minimum (1 point) for typical reflux symptoms in the modified FSSG.
Of the 280 RE patients, 71.8% (n = 201) were symptomatic and 28.2% (n = 79) were asymptomatic. The atypical symptom scores were significantly lower in asymptomatic RE (2.2 ± 2.2) than in symptomatic RE patients (6.9 ± 5.2) (P < 0.0001), and the HRQOL scores were significantly higher in asymptomatic RE than in symptomatic RE (P < 0.0001). Sleep was significantly less disturbed and chronic cough less frequent in asymptomatic RE than in symptomatic RE.
Frequency and severity of atypical symptoms in patients with asymptomatic RE were significantly less than in patients with symptomatic RE, and the HRQOL score was significantly higher in those patients. These observations suggest a specific patient cohort that is truly unlikely to manifest symptoms.
无症状反流性食管炎（RE）仅被视为无典型反流症状的RE，但无症状RE患者是否存在非典型症状尚不清楚。本研究旨在探讨无症状RE患者的临床特征及健康相关生活质量（HRQOL）。
连续纳入2010年1月至2012年8月期间的RE患者，其中41例服用过抑酸药物的患者被排除，剩余280例患者作为研究组。使用自行填写的问卷（改良的胃食管反流病症状频率量表[FSSG]）以及HRQOL问卷（SF - 8）对患者症状进行评估。我们将RE的典型症状定义为烧心和反流。如果改良FSSG中典型反流症状的总症状评分为0或最低分（1分），则定义为无症状RE。
280例RE患者中，71.8%（n = 201）有症状，28.2%（n = 79）无症状。无症状RE患者的非典型症状评分（2.2±2.2）显著低于有症状的RE患者（6.9±5.2）（P < 0.0001），无症状RE患者的HRQOL评分显著高于有症状的RE患者（P < 0.0001）。与有症状的RE相比，无症状RE患者睡眠受干扰明显更少，慢性咳嗽频率更低。
无症状RE患者非典型症状的频率和严重程度显著低于有症状的RE患者，且前者的HRQOL评分显著更高。这些观察结果提示存在一个真正不太可能出现症状的特定患者群体。
