上海交通大学学报（医学版）

上海交通大学学报（医学版） >

2021 , Vol. 41 >Issue 12: 1677 - 1682

DOI: https://doi.org/10.3969/j.issn.1674-8115.2021.12.019

论著 · 公共卫生

胃食管反流病患者健康相关生命质量及其影响因素分析

  • 高紫云 ,
  • 严宇青 ,
  • 童天颖 ,
  • 宁立军 ,
  • 洪洁 ,
  • 王震华
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  • 上海交通大学医学院附属仁济医院消化内科，上海 200001
高紫云（1995—），女，硕士生；电子信箱：gaoziyun1995@163.com。
王震华，电子信箱：zhenhuawang@126.com。#为共同通信作者。
洪 洁，电子信箱：jiehong97@sjtu.edu.cn

收稿日期: 2021-05-26

  网络出版日期: 2021-01-28

基金资助

上海市教育委员会高峰高原学科建设计划(20152512)

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Health-related quality of life and its influencing factors among patients with gastroesophageal reflux disease

  • Zi-yun GAO ,
  • Yu-qing YAN ,
  • Tian-ying TONG ,
  • Li-jun NING ,
  • Jie HONG ,
  • Zhen-hua WANG
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  • Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
WANG Zhen-hua, E-mail: zhenhuawang@126.com. #Co-corresponding author.
HONG Jie, E-mail: jiehong97@sjtu.edu.cn

Received date: 2021-05-26

  Online published: 2021-01-28

Supported by

Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support(20152512)

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摘要

目的·探讨胃食管反流病（gastroesophageal reflux disease，GERD）对患者健康相关生活质量（health-related quality of life，HRQoL）的影响及相关影响因素。方法·对2019年5月至12月于上海交通大学医学院附属仁济医院消化内科门诊就诊的108例GERD患者进行欧洲五维健康量表（EuroQol 5-Dimensions Instrument with 5-Level Scale，EQ-5D-5L）调查以评估其HRQoL，并采用GERD-Q自测量表评估患者的临床症状，同时收集社会人口学与疾病相关信息以及医疗支出的数据。Fisher精确概率检验用于比较各个维度中有健康问题的患者数量和比例。采用单变量Tobit模型筛选与EQ-5D-5L效用值有相关性的影响因素，进一步采用普通最小二乘法（ordinary least squares，OLS）及Logistic回归模型探讨影响因素与HRQoL的关系。结果·108例患者中，EQ-5D-5L的平均效用值为0.855，标准差（standard deviation，SD）为0.162。在体质量指数（body mass index，BMI；P=0.000）、性别（P=0.000）、内镜分级（P=0.000）、GERD-Q得分（P=0.049）、药物及医疗支出（P=0.000）的亚组中，报告有健康问题的患者数差异具有统计学意义。在OLS回归模型中发现GERD-Q得分≥8分、治疗费用高对HRQoL有负面影响（均P<0.05），而使用抗酸药有积极作用（P<0.05）。在Logistic回归中，病程（OR=1.222，P=0.050）、使用抗酸药（OR=10.808，P=0.044）与HRQOL呈正相关。结论·GERD会降低患者的HRQoL，需要社会的支持及医疗决策者的关注。

关键词： 胃食管反流病; 欧洲五维健康量表（EQ-5D-5L）; 健康相关生活质量

本文引用格式

高紫云 , 严宇青 , 童天颖 , 宁立军 , 洪洁 , 王震华 . 胃食管反流病患者健康相关生命质量及其影响因素分析[J]. 上海交通大学学报（医学版）, 2021 , 41(12) : 1677 -1682 . DOI: 10.3969/j.issn.1674-8115.2021.12.019

Abstract

Objective

·To evaluate the health-related quality of life (HRQoL) of patients with gastroesophageal reflux disease (GERD), and to explore the related factors.

Methods

·EuroQol 5-Dimensions Instrument with 5-Level Scale (EQ-5D-5L) questionnaire was conducted on 108 GERD patients who visited the Gastroenterology Clinic of Renji Hospital, Shanghai Jiao Tong University School of Medicine from May to December 2019. GERD-Q questionnaire was used to assess their clinical symptoms. Other data including sociodemographic characteristics, disease-related information and medical costs were collected at the same time. Fisher's exact test was used to compare the amount and proportion of patients who had health problems in each dimension. The univariate Tobit model was used to select the influencing factors that were correlated with the EQ-5D-5L utility. Multivariate regression analysis such as the ordinary least squares (OLS) and Logistic regression model were employed to explore the factors affecting HRQoL of GERD patients.

Results

·In the 108 patients, the average EQ-5D-5L utility score was 0.855 with a standard deviation (SD) of 0.162. In the subgroups of body mass index (BMI) (P=0.000), gender (P=0.000), endoscopy grade (P=0.000), GERD-Q score (P=0.049), medication and medical expenditures (P=0.000), the difference of proportion of patients who reported they had health problem were statistically significant. In OLS model, GERD-Q score greater than/equal to 8 and the higher medical expenditure had a negative impact on HRQoL (P<0.05), while use of antacids had a positive effect (P<0.05). Logistic regression analysis indicated that disease duration (OR=1.222, P=0.050) and use of antacids (OR=10.808, P=0.044) had positive relationship with HRQoL.

Conclusion

·GERD could decrease the HRQoL of patients, and it requires the support and attention of medical decision-makers.

Key words： gastroesophageal reflux disease (GERD); EuroQol 5-Dimensions Instrument with 5-Level Scale (EQ-5D-5L); health-related quality of life (HRQoL)

参考文献

1 Maret-Ouda J, Markar SR, Lagergren J. Gastroesophageal reflux disease: a review[J]. JAMA, 2020, 324(24): 2536-2547.
2 Nirwan JS, Hasan SS, Babar ZU, et al. Global prevalence and risk factors of gastro-oesophageal reflux disease (GORD): systematic review with meta-analysis[J]. Sci Rep, 2020, 10(1): 5814.
3 Mason J, Hungin AP. Review article: gastro-oesophageal reflux disease: the health economic implications[J]. Aliment Pharmacol Ther, 2005, 22(): 20-31.
4 Sandler RS, Everhart JE, Donowitz M, et al. The burden of selected digestive diseases in the United States[J]. Gastroenterology, 2002, 122(5): 1500-1511.
5 Wiklund I. Review of the quality of life and burden of illness in gastroesophageal reflux disease[J]. Dig Dis Basel Switz, 2004, 22(2): 108-114.
6 Devlin NJ, Brooks R. EQ-5D and the EuroQol Group: past, present and future[J]. Appl Health Econ Health Policy, 2017, 15(2): 127-137.
7 Kahrilas PJ, Shaheen NJ, Vaezi MF. American Gastroenterological Association Medical Position Statement on the management of gastroesophageal reflux disease[J]. Gastroenterology, 2008, 135(4): 1383-1391.e5.
8 Luo N, Liu G, Li M, et al. Estimating an EQ-5D-5L value set for China[J]. Value Health, 2017, 20(4): 662-669.
9 Jones R, Junghard O, Dent J, et al. Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care[J]. Aliment Pharmacol Ther, 2009, 30(10): 1030-1038.
10 Armstrong D, Bennett JR, Blum AL, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement[J]. Gastroenterology, 1996, 111(1): 85-92.
11 Yang ZH, Busschbach J, Liu G, et al. EQ-5D-5L norms for the urban Chinese population in China[J]. Heal Qual Life Outcomes, 2018, 16(1): 210.
12 Chen M, Xiong L, Chen H, et al. Prevalence, risk factors and impact of gastroesophageal reflux disease symptoms: a population-based study in South China[J]. Scand J Gastroenterol, 2005, 40(7): 759-767.
13 Wang R, Wang J, Hu S. Study on the relationship of depression, anxiety, lifestyle and eating habits with the severity of reflux esophagitis[J]. BMC Gastroenterol, 2021, 21(1): 127.
14 Ofman JJ. The economic and quality-of-life impact of symptomatic gastroesophageal reflux disease[J]. Am J Gastroenterol, 2003, 98(3): S8-S14.
15 Eusebi LH, Ratnakumaran R, Yuan Y, et al. Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis[J]. Gut, 2018, 67(3): 430-440.
16 Jacobson BC, Somers SC, Fuchs CS, et al. Body-mass index and symptoms of gastroesophageal reflux in women[J]. New Engl J Med, 2006, 354(22): 2340-2348.
17 Kohata Y, Fujiwara Y, Watanabe T, et al. Long-term benefits of smoking cessation on gastroesophageal reflux disease and health-related quality of life[J]. PLoS One, 2016, 11(2): e0147860.
18 Eslick GD, Talley NJ. Gastroesophageal reflux disease (GERD): risk factors, and impact on quality of life-a population-based study[J]. J Clin Gastroenterol, 2009, 43(2): 111-117.
19 Lee SW, Chang CM, Chang CS, et al. Comparison of presentation and impact on quality of life of gastroesophageal reflux disease between young and old adults in a Chinese population[J]. World J Gastroenterol, 2011, 17(41): 4614-4618.
20 Hongo M, Miwa H, Kusano M, et al. Symptoms and quality of life in underweight gastroesophageal reflux disease patients and therapeutic responses to proton pump inhibitors[J]. J Gastroenterol Hepatol, 2012, 27(5): 913-918.
21 Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease[J]. Am J Gastroenterol, 2013, 108(3): 308-328.
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