Esophageal dynamics detection and clinical characteristics of patients with gastroesophageal reflux disease in peri-menopausal period
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摘要:目的 探讨围绝经期女性胃食管反流病(GERD)的食管动力学特点和临床特点。方法 选取110例GERD女性患者作为研究对象，根据月经情况将患者分为围绝经期组45例和非围绝经组65例。分析并比较2组GERD患者的食管动力学特点、典型症状发生率和非典型症状发生率。结果 围绝经期组反酸症状发生率为44.45%, 显著低于非围绝经组的52.31%(P < 0.05); 2组反食症状和胃灼热症状发生率比较，差异无统计学意义(P>0.05)。非典型症状中，2组患者咽喉炎和咽部异物感发生率均较高; 围绝经期组嗳气发生率为53.33%显著高于非围绝经组的29.23%, 睡眠障碍发生率为55.56%显著高于非围绝经组的27.69%(P < 0.05)。围绝经期组、非围绝经组GERD患者的胃食管反流病问卷(GerdQ)积分分别为(9.57±1.82)、(9.87±2.25)分，差异无统计学意义(P>0.05)。2组GERD患者的总反流次数、酸反流次数及非酸反流次数无显著差异(P>0.05)。围绝经期组与非围绝经组的弱酸反流次数有显著差异(P < 0.05)。结论 围绝经期女性GERD大多表现为非典型症状，主要是咽喉炎和咽部异物感，食管动力学检测可以作为诊断围绝经期女性GERD的重要选择。Abstract:Objective To study the esophageal dynamics characteristics and clinical features of peri-menopausal women with gastroesophageal reflux disease (GERD).Methods A total of 110 female patients with GERD who were treated in our hospital were selected as subjects. According to menstrual conditions, these patients were divided into perimenopausal group (n=45) and non-peri-menopausal group (n=65). The esophageal motility characteristics, incidences of typical symptom and atypical symptom of GERD patients were analyzed and compared.Results The incidence of acid reflux symptoms in the perimenopausal group was significantly lower than that in the non-peri-menopausal group (44.45% vs. 52.31%, P < 0.05). There was no significant difference in the incidence of antifeedant symptoms and heartburn symptoms (P>0.05). Among the atypical symptoms, the incidence of pharyngitis and pharyngeal foreign body sensation was higher in the two groups; the incidence of belching in the perimenopausal group was significantly higher than that in the non-peri-menopausal group (53.33%vs. 29.23%, P < 0.05), the incidence of sleep disorder was significantly higher than that of non-peri-menopausal group (55.56% vs. 27.69%, P < 0.05). The GerdQ scores of peri-menopausal and non-peri-menopausal GERD patients were (9.57±1.82) and (9.87±2.25), respectively, but showed no significant difference(P>0.05). There were no significant differences in the total number of reflux, acid reflux and non-acid reflux in the peri-menopausal group and non-peri-menopausal group (P>0.05). The number of weak acid reflux in the two groups had significant difference (P < 0.05).Conclusion Peri-menopausal women with GERD mostly have atypical symptoms such as pharyngitis and pharyngeal foreign body sensation. Esophageal dynamics test can be used as an important indicators for the diagnosis of peri-menopausal women with GERD.
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Keywords:
- peri-menopause /
- gastroesophageal reflux /
- esophageal dynamics /
- clinical symptoms
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表 1 2组患者典型症状发生情况比较[n(%)]
组别 n 反酸 胃灼热 反食 围绝经期组 45 20(44.45) 28(62.22) 25(55.56) 非围绝经期组 65 34(52.31)* 44(67.69) 39(60.00) 与围绝经期组比较, *P < 0.05。 
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表 2 2组患者非典型症状发生情况比较[n(%)]
症状 围绝经期组(n=45) 非围绝经期组(n=65) 咽喉炎 24(53.33) 29(44.62) 吞咽困难 6(13.33) 11(16.92) 咽部异物感 27(60.00) 36(55.38) 嗳气 24(53.33) 19(29.23)* 睡眠障碍 25(55.56) 18(27.69)* 与围绝经期组比较, *P < 0.05。
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表 3 2组患者24 h食管阻抗-pH监测结果比较[M(P25, P75)]
次 指标 围绝经期组 非围绝经期组 总反流 42.0(26.0, 64.0) 40.0(24.3, 59.7) 酸反流(pH值<4) 29.0(27.0, 45.0) 31.0(24.5, 46.7) 弱酸反流(pH值4~7) 11.0(8.0, 17.8) 7.0(6.8, 16.9)* 非酸反流(pH值>7) 1.7(0.3, 2.9) 1.2(0, 4.1) 与围绝经期组比较, *P < 0.05。
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