Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China.
J Dig Dis. 2019 Oct;20(10):523-531. doi: 10.1111/1751-2980.12799. Epub 2019 Sep 3.
To explore the natural history of and risk factors for gastroesophageal reflux (GER) in a prospective cohort in Beijing, China.
We selected adult participants using a stratified randomized method and performed initial surveys in 1996 and the current survey in 2008. Well-trained investigators administered the survey questionnaire using face-to-face interviews. Reflux symptoms were evaluated by their intensity and frequency. GER was defined as heartburn, acid reflux, and food regurgitation at least once a week, and monthly reflux was defined as at least one of the above symptoms occurring 1-3 days per month.
The resurvey response rate was 47.8% (1189/2486). Over 12 years, 66.9% of the respondents remained unchanged, and one-third changed, with a GER new onset rate of 7.0 per 1000 person-years and a GER disappearance rate of 64.6 per 1000 person-years. This kept the GER prevalence stable at 8.2% to 9.5% (P = 0.28). GER and monthly reflux exhibited significant differences in their tendency to persist or become aggravated to GER (22.4% vs 11.9%, P = 0.02). Participants who initially had single, mild to moderate, daily GER were more likely to recover from reflux over time. Participants with persistent and aggravated GER had more severe heartburn and acid reflux than those with new-onset GER in the current survey. Multiple logistic regression analysis showed that emotional depression is a risk factor for GER aggravation (odds ratio 3.52, 95% confidence interval 1.43-8.67, P = 0.006).
The initial symptom profile of reflux determines the outcome of GER over time.
在中国北京的一个前瞻性队列中，探索胃食管反流（GER）的自然史和危险因素。
我们采用分层随机方法选择成年参与者，并于 1996 年进行初始调查，于 2008 年进行当前调查。经过培训的调查员使用面对面访谈的方式进行问卷调查。反流症状通过其强度和频率进行评估。GER 定义为每周至少一次烧心、反酸和食物反流，每月反流定义为每月至少出现上述症状 1-3 天。
再调查的应答率为 47.8%（1189/2486）。12 年间，66.9%的受访者保持不变，三分之一的受访者发生变化，GER 的新发病率为 7.0/1000 人年，GER 的消失率为 64.6/1000 人年。这使得 GER 的患病率保持在 8.2%至 9.5%之间（P=0.28）。GER 和每月反流在持续或加重为 GER 的趋势上存在显著差异（22.4%比 11.9%，P=0.02）。最初表现为单次、轻度至中度、每日 GER 的参与者随着时间的推移更有可能从反流中恢复。在当前调查中，持续性和加重性 GER 的参与者比新发 GER 的参与者有更严重的烧心和反酸。多因素逻辑回归分析显示，情绪抑郁是 GER 加重的危险因素（比值比 3.52，95%置信区间 1.43-8.67，P=0.006）。
初始反流症状谱决定了 GER 的长期结局。
