医学诊断  >> Vol. 3 No. 4 (December 2013)

老年GERD患者的临床特征及诊治进展
Clinical Manifestations of GERD Aged Patients and Progress of Treatment

DOI: 10.12677/MD.2013.34011, PDF, HTML, 下载: 2,225  浏览: 7,692 

作者: 张小兰, 潘庆敏, 严 洁, 张小乔, 陈 芳, 屈 红:湖北医药学院附属太和医院老年科,十堰

关键词: 老年患者胃食管反流病食道外表现治疗 Aged Patients; Gastroesophageal Refux Disease; Extra Esophageal Symptoms; Treatment

摘要: 目的:分析老年胃食管反流病(gast roesophageal reflux disease, GERD)患者临床症状特征,并观察疗效。方法:随机选取2011-01/2012-01我院消化内科、老年科门诊及住院部病房符合GERD诊断的患者1000例,将患者分为2组,老年组500(60)和非老年组500(<60)。比较2组患者各种症状的发生率以及综合治疗前后RDQ量表评分变化。结果:GERD患者老年组食道外症状的发生率明显高于非老年组(P < 0.01),综合治疗后与治疗前比较RDQ量表评分均数明显下降(老年组:7.53 ± 3.31 vs 15.63 ± 3.54P < 0.01;非老年组:6.22 ± 4.52 vs 16.54 ± 5.61P < 0.01)2组综合治疗均有明显疗效。结论:老年GERD患者应注意鉴别诊断及多系统综合治疗,才能达到全面康复的疗效。 Aim: To analyze the clinical symptoms of aged patients with gastroesophageal reflux disease (GERD) and to observe the curative effect of comprehensive treatment for GERD. Methods: One thousand out-patients who met the criteria for GERD in our hospital from January 2011 to January 2012 were randomly chosen and allocated to two groups: aged patient group (≥60, n = 500) and non-aged patient group (<60, n = 500). Incidence rate of each symptom was analyzed and compared between two groups. RDQ scores of patients before and after the treatment were estimated. Results: The rates of extra esophageal symptoms in aged group were markedly higher than those in non-aged group (P < 0.01); RDQ scores of GERD patients reduced significantly after comprehensive treatment (aged group: 7.53 ± 3.31 vs 15.63 ± 3.54, P < 0.01; non-aged group: 6.22 ± 4.52 vs. 16.54 ± 5.61, P < 0.01). Remarkable curative effect was observed in both groups. Conclusion: For aged GERD patients, more importance should be attached to differential diagnosis and comprehensive treatment for a complete recovery.

文章引用: 张小兰, 潘庆敏, 严洁, 张小乔, 陈芳, 屈红. 老年GERD患者的临床特征及诊治进展[J]. 医学诊断, 2013, 3(4): 48-50. http://dx.doi.org/10.12677/MD.2013.34011

参考文献

[1] Lim, S.L., Goh, W.T., Lee, J.M., Ng, T.P. and Ho, K.Y. (2005) Changing prevalence of gastroesophageal reflux with changing time: Longitudinal study in an Asian population. Journal of Gastroenterology and Hepatology, 20, 995-1001.
[2] 中国胃食管反流病研究协作组 (2003) 反流性疾病问卷在胃食管反流病诊断中的价值. 中华消化杂志, 23, 651-654.
[3] 李长城, 石丽楠 (2012) 老年胃食管反流病患者临床症状及心理障碍分析. 中国实用医药, 19, 82-83.
[4] 朱国玲, 张杰, 张海玲 (2012) 老年与青年胃食管反流病患者临床特征多中心对照研究. 中国医药导报, 25, 52-54.
[5] 梁振平 (2012) 老年胃食管反流病患者的心理状况和生活质量. 中国老年学杂志, 32, 1461-1462.
[6] 陈健, 乔瑞敏 (2006) 食管源性胸痛50例临床分析. 中华全科医师杂志, 5, 116-117.
[7] 郭荣斌, 彭丽华, 程留芳, 王巍峰 (2004) 老年胃食管反流病患者食管运动功能改变. 世界华人消化杂志, 12, 125-128.
[8] 夏俊, 刘健, 姚健风, 尹曙明, 虞阳, 于晓峰, 赵尚敏 (2004) 问询表诊断老年胃食管反流病的临床评价. 老年医学与保健, 3, 35-37.
[9] Tack, J. and Fass, R. (2004) Review article: Approaches to endoscopic 2 negative reflux disease: Part of the GERD spectrum or a unique acid 2 related disorder. Alimentary Pharmacology & Therapeutics, 19, 28-34.
[10] Sarkar, S., Thompson, D.G., Woolf, C.J., et al. (2004) Patient with chest pain and occult gastroesophageal reflux demonstrate visceral pain hypersensitivity which may be partially responsive to acid suppression. The American Journal of Gastroenterology, 99, 1998-2006.
[11] Lembo, A.J. (2004) Visceral hypersensitivity in norcardiac chest- pain. Gastroenterology Clinics of North America, 33, 55-60.
[12] 梁小燕, 高青 (2006) 胃食管反流病的食管外表现及其临床进展. 世界华人消化杂志, 14, 3387-3390.
[13] 牛春燕, 闰蓉,吴方雄等 (20l2) 西安地区老年胃食管反流病发病情况调查. 胃肠病学和肝病学杂志, 21, 1116-1121.
[14] Shimizu, Y., Dobashi, K., Kobayashi, S., Ohki, I., Tokushima, M., Kusano, M., Kawamura, O., Shimoyama, Y., Utsugi, M., Sunaga, N., Ishizuka, T. and Mori, M. (2006) A proton pump inhibitor, lansoprazole, ameliorates asthma symptoms in asthmatic patients with gastroesophageal refux disease. The Tohoku Journal of Experi-mental Medicine, 209, 181-189.
[15] Calabrese, C., Fabbri, A., Areni, A., Scialpi, C., Zahlane, D. and Di Febo, G. (2005) Asthma and gastroesophageal refux disease: Effect of long-term pantoprazole therapy. World Journal of Gastroenterology, 11, 7657-7660.