目的：利用完整的前瞻性功能性胃肠病数据库探讨非糜烂性胃食管反流病（NERD）的相关发病因素与临床特点。方法按照病例报告表（CRF）收集完整的个人信息和临床资料，将各项信息与资料录入到网络在线功能性胃肠病数据管理系统，部分病例完成高分辨率食管测压和多通道腔内阻抗-pH监测，导出检索数据进行统计分析。结果在数据库中录入了504例NERD临床资料及152例对照组资料，NERD患者中，女性266例（52.8%）、男性238例（47.2%）；商人（23.1%）、公务员（19.6%）、无业（19.2%）、工人（17.1%），城市病源（67.3%）、农村病源（32.7%）；平均病程（27.88±16.33）月；不良生活事件（P=0.045，OR=1.954）、长期频繁饮酒（P=0.040，OR=3.957）、打鼾（P=0.002，OR=2.334）、进食夜宵（P=0.002，OR=2.752）、合并焦虑抑郁（P=0.003，OR=2.723）等是NERD的独立危险因素；60.81%NERD患者存在不同程度的食管体部无效收缩，其中存在食管裂孔疝（HH）与无HH的NERD患者两组之间在总液体反流事件方面存在明显差异（P<0.05）。结论不良生活与饮食习惯、焦虑抑郁与不良事件、打鼾、食管运动功能差、HH等与NERD的发病具有重要相关性，30~50岁为高发人群，并与职业和生活区域有一定相关。%Objective To explore the risk factors and clinical characteristics of non-erosive reflux disease (NERD) based on a prospective single disease database of functional gastrointestinal disease. Methods Using a customized case report form, we collected the personal and clinical data of all study participants in an online database for further analysis. High-resolution manometry and multichannel intraluminal impedance-pH monitoring were performed in some cases. Results A total of 504 NERD cases and 152 control cases were included in our database. The NERD patients consisted of 266 (52.8%) female patients and 238 (47.2%) male patients;32.7%of the patients were from rural areas and 67.3%from urban areas;23.1%of the patients worked in the line of business, 19.6%were civil servants, 19.2%were unemployed, and 17.1%were workers;the mean disease duration of the patients was 27.88±16.33 month. Our analysis showed that adverse events in life (P=0.045, OR=1.954), frequent drinking (P=0.040, OR=3.957), snoring (P=0.002, OR=2.334), late meals (P=0.002, OR=2.752), and anxiety or depression (P=0.003, OR=2.723) were all independent risk factors for NERD. Of these patients, 60.81%had varying degrees of ineffective contraction of the esophageal body. The total liquid reflux events differed significantly between NERD patients with hiatal hernia and those without (P<0.05). Conclusion Unhealthy eating habits and lifestyle, history of adverse events, anxiety and depression, snoring, poor esophageal motor function and hiatal hernia are significant factors contributing to NERD, which is related with occupation and living areas and occurs most commonly at 30-50 years of age.
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