Objective: To investigate the relationship between gastroesophageal reflux disease (GERD) and obstructive sleep apnea syndrome(OSAS). Methods: Patients diagnosed as GERD and healthy controls without GERD related symptoms or endoscopic esophagitis were enrolled from October 2017 and December 2017. All subjects completed Berlin Questionaire to assess the risk of OSAS. Univariate and multivariate logistic regression models were applied to identify risk factors of OSAS. Results: A total of 177 subjects (97 GERD, 80 controls) were finally selected. Significantly more patients in GERD group had high risk OSAS than those in controls [36.1%(35/97) vs. 17.5%(14/80), P=0.005]. In GERD group, patients with erosive reflux diseases (ERD) had especially higher proportion of high risk OSAS compared with the non-ERD group and the healthy controls [53.3% (24/45) vs. 20.8% (10/48) and 17.5% (14/80), P=0.001]. On univariate analysis, male, aging and reflux esophagitis were identified as risk factors of OSAS (all P<0.01). On multivariate analysis, male (OR=12.156, 95%CI 1.382-106.905, P=0.024), aging (OR=1.132, 95%CI 1.051-1.220, P=0.001), acid regurgitation with reflux esophagitis (OR=5.157, 95%CI 1.327-20.034, P=0.018) were significant risk factors. Conclusions: More GERD patients are combined with high risk OSAS than controls, especially subjects with reflux esophagitis. Male and aging GERD patients with acid regurgitation and reflux esophagitis need further evaluation on OSAS screening.
目的: 探讨胃食管反流病(GERD)与阻塞性睡眠呼吸暂停综合征(OSAS)发生风险的关系。 方法: 采用病例对照研究的方法,选取2017年10至12月诊断为GERD的患者作为GERD组,同期无上消化道症状主诉且无食管炎的体检者作为对照组,通过Berlin问卷评估OSAS发生风险(分为高危、低危)。采用单因素、多因素logistic回归模型计算各组发生高危OSAS的OR值及其95% CI。 结果: 共纳入177例受试者,其中GERD组97例,对照组80例。GERD组高危OSAS发生率高于对照组[36.1%(35/97)比17.5%(14/80),P=0.005],其中反流性食管炎患者的高危OSAS发生率明显高于非糜烂性反流病患者及对照组[53.3%(24/45)比20.8%(10/48)、17.5%(14/80),P=0.001]。单因素回归分析显示,男性、年龄、反流性食管炎是GERD患者发生高危OSAS的危险因素(P值均<0.01);进一步多因素回归分析显示,男性(OR=12.156,95%CI 1.382~106.905, P=0.024)、年龄(OR=1.132,95%CI 1.051~1.220, P=0.001)、反酸合并反流性食管炎(OR=5.157, 95%CI 1.327~20.034, P=0.018)是GERD患者发生高危OSAS的独立危险因素。 结论: GERD患者合并高危OSAS的发生率高于普通人群,其中反流性食管炎合并OSAS的发生率更高。男性、年长、反酸合并反流性食管炎的GERD患者应重视有合并OSAS的可能,并做进一步OSAS监测。.
Keywords: Case-control studies; Gastroesophageal reflux; Sleep apnea, obstructive.