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目的了解中国不同地区医生胃食管反流病(GERD)的发病和诊治情况。方法中国医师协会消化医师分会采用随机抽样问卷方式,于2006年2月—6月在全国不同地区医院中对患有GERD的医生的发病和诊治情况进行调查。结果1010例患有GERD的医生接受调查,男性567例、女性419例,男女性别比为1.35:1,平均年龄为(41.1±10.3)岁,其中患病年龄以30～40岁最为多见。在胃食管反流症状中烧心502例(49.7%),胸骨后痛325例(32.2%),嗳气319例(31.6%),上腹痛313例(31.1%),咽部吞咽异物感88例(8.7%)。在被调查对象中467例(46.2%)曾行胃镜检查,食管黏膜正常者339例,占76.0%;反流性食管炎102例,占21.8%;Barrett食管10例,占2.2%。89.3%的被调查者曾服用质子泵抑制剂(PPI)治疗,平均起效时间为(13.2±36.5)h,服用药物的满意度为91.0%。相关分析显示年龄及性别与胃镜检查结果无相关性,临床症状及其严重程度与胃镜检查结果亦无相关性。回归分析显示症状缓解时间(P=0.0065)及服药方式(P=0.0003)与服用药物满意度存在负相关。结论患有GERD的中国医生临床症状主要表现为烧心、胸骨后痛、嗳气和上腹痛,胃镜检查是诊断反流性食管炎的重要依据,多数被调查者胃镜下表现为食管黏膜正常,选择服用PPI治疗疗效的满意度高。
Objective To understand the incidence and diagnosis and treatment of gastroesophageal reflux disease (GERD) in different regions of China. Methods The Chinese Medical Doctor’s Digesting Physician Sub-council adopted a random sampling questionnaire to investigate the incidence and diagnosis and treatment of doctors with GERD in hospitals in different regions of the country from February to June 2006. Results One hundred and ten patients with GERD were enrolled in this study. There were 567 males and 419 females, with a sex ratio of 1.35: 1 for men and women and an average age of (41.1 ± 10.3) years. The prevalence was 30 to 40 years old. 502 (49.7%) had heartburn, 325 (32.2%) had post-sternal pain, 319 (31.6%) had belching, 313 (31.1%) had upper abdominal pain, and 88 8.7%). Among 467 cases (46.2%) who underwent gastroscopy, 339 had normal esophageal mucosa (76.0%), 102 had reflux esophagitis (21.8%), and 10 had Barrett’s esophagus (2.2%). 89.3% of the respondents had taken proton pump inhibitor (PPI) treatment, the average onset time was (13.2 ± 36.5) h, the drug satisfaction was 91.0%. Correlation analysis showed no correlation between age and sex and gastroscopy results, clinical symptoms and severity and gastroscopy did not show any correlation. Regression analysis showed that the time to symptom relief (P = 0.0065) and medication regimen (P = 0.0003) were negatively correlated with medication satisfaction. Conclusion The clinical symptoms of Chinese doctors with GERD are mainly heartburn, post-sternum pain, belching and upper abdominal pain. Gastroscopy is an important basis for the diagnosis of reflux esophagitis. Most of the respondents underwent gastroscopy showed normal esophageal mucosa, choose to take PPI treatment of high satisfaction.