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在亚洲睡眠诊所转诊患者中胃食管反流病与睡眠紊乱之间的关系

2017/10/09

   摘要
   目的:关于胃食管反流病(GERD)与睡眠呼吸暂停综合征的研究结论各异,而且关于GERD与其他睡眠紊乱疾病之间的研究较少。本研究的目的在于评估睡眠紊乱各级参数与GERD之间的关系。
   方法:共564名转诊至睡眠实验室的患者纳入研究,并接受夜间多导睡眠监测及完成关于GERD的调查问卷。问卷一共包含14个项目及7个反流相关症状问题(如烧心、反酸、胸痛、声音嘶哑、异物感、咳嗽、上腹痛)。其中GERD组的诊断依据为出现烧心或反酸症状每周至少1次。
   结果:在564名入组患者中,51人(9%)诊断为GERD。GERD组患者的Beck抑郁量表评分(p<.01),Epworth嗜睡量表评分(p=.03),匹兹堡睡眠质量指数(p<.01),觉醒及嗜酒量较非GERD组患者高。其中GERD与抑郁相关改变、体重指数之间无明显相关,与睡眠质量差(调整后OR=0.035;95%CI(1.3-9.3))及抑郁情况(调整后OR=2.8;95%CI(1.5-5.3))存在明显相关。
   结论:GERD与主观睡眠质量差及抑郁症状有关,与SAS评分,BMI无关。对于GERD患者,需要评估其心理状态及睡眠症状并给于适当治疗。
 
 
(中国医科大学附属一院呼吸与危重症学科 李文扬 摘译 杨冬 审校)
(J Psychosom Res. 2013 ;75(6):551-5.)
 
 
 
Relationships between sleep disturbances and gastroesophageal reflux disease in Asian sleep clinic referrals.
 
Ju G, Yoon IY, Lee SD, Kim N.
 
Abstract
OBJECTIVE:Studies on the association between gastroesophageal reflux disease (GERD) and sleep apnea syndrome (SAS) have reported conflicting results, and attention has not been paid to the relationship between GERD and other sleep disorders. The aim of the study was to evaluate the relationship between GERD and various aspects of sleep disturbances.
METHODS:A total of 564 subjects who were referred to a sleep laboratory were enrolled in the study. They underwent nocturnal polysomnography (NPSG), and they were asked to complete a GERD questionnaire. The questionnaire consisted of 14 items, and included questions on seven reflux symptoms, namely, heartburn, acid regurgitation, chest pain, hoarseness, globus sensation, coughing and epigastric soreness. Subjects reporting heartburn or acid regurgitation at least once a week were classified as having GERD.
RESULTS:Among 564 participants, 51 subjects (9.0%) were diagnosed as having GERD. GERD patients had higher scores in Beck depression inventory (p<.01), Epworth sleepiness scale (p=.03), Pittsburg sleep quality index (p<.01), more spontaneous arousals in NPSG, and more alcohol consumption than non-GERD patients. There was no association between presence of GERD, SAS-related variables, and body mass index (BMI). GERD was significantly associated with poor sleep quality (adjusted OR, 3.5; 95% CI, 1.3-9.3) and depressed mood (adjusted OR, 2.8; 95% CI, 1.5-5.3).
CONCLUSION:Poor subjective sleep and depressive symptoms are associated with the presence of GERD with no association between SAS, BMI and GERD. In managing patients with GERD, psychiatric and sleep symptoms need to be evaluated and appropriately treated.
 


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