探究肥胖合并胃食管反流病（GERD）患者的病情严重程度与其焦虑抑郁及营养状态的相关性。

回顾性分析2021年1月至2023年6月广汉市中医医院收治的120例GERD患者的临床资料。根据患者的体重指数（BMI），将68例18.5 kg/m²≤BMI<24.0 kg/m²的GERD患者分为对照组，52例BMI≥28 kg/m²的GERD患者分为观察组。比较两组患者的一般基线资料、食管动力学指标、汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HAMD）评分、微型营养评估（MNA）评分，采用Pearson法分别分析肥胖合并GERD患者的病情严重程度与其焦虑抑郁和营养状态的相关性。

观察组患者的Gerd Q评分显著高于对照组（12.32±1.49比9.27±1.58，P<0.05），且中、重度患者比例高于对照组。观察组的食管括约肌压力显著低于对照组[（1.83±0.28）kPa比（3.42±0.34）kPa，P<0.05]；观察组的立位反流时间[（4.52±1.36）%]、卧位反流时间比[（4.83±1.27）%]和总反流时间[（3.49±1.02）%]均显著高于对照组（P<0.05）；观察组的HAMA评分（19.37±0.36）和HAMD评分（17.73±0.83）均显著高于对照组（P<0.05）。此外，观察组中营养正常的患者比例显著低于对照组（19.23%比51.47%，P<0.05），而潜在营养不良的患者比例显著高于对照组（57.69%比27.94%），P<0.05。相关性分析表明，观察组患者的DeMeester积分与HAMA评分、HAMD评分呈正相关（r=0.707 9、0.814 8，均P<0.000 1），与MNA评分呈负相关（r=－0.887 1，P<0.000 1）。

与体重处于正常范围的GERD患者相比，肥胖GERD患者的病情更加严重，食管功能和营养吸收能力显著下降，焦虑抑郁情绪更加明显，且其病情严重程度与焦虑抑郁程度和营养状态显著相关。

To investigate the correlation between the severity of obesity combined with gastroesophageal reflux disease (GERD) patients and their anxiety, depression and nutritional status.

The clinical data of 120 patients with gGERD admitted to Guanghan Hospital of Traditional Chinese Medicine from January 2021 to June 2023 were retrospectively analyzed. According to the patients' body mass index (BMI), GERD patients with weight in the normal range (18.5 kg/m²≤BMI<24.0 kg/m²) were divided into the control group (n=68), and obesity (BMI≥28 kg/m²) combined GERD patients were divided into the observation group (n=52). General baseline data, esophageal dynamics indexes, Hamilton Anxiety Scale (HAMA) scores, Hamilton Depression Scale (HAMD) scores, and Mini Nutritional Assessment (MNA) scores of the two groups were compared, and the correlation between the severity of the condition of patients with obesity combined GERD and their anxiety, depression and nutritional status was analyzed by Pearson method, respectively.

The Gerd Q score of the observation group was significantly higher than that of the control group (12.32±1.49 vs. 9.27±1.58, P<0.05), and the proportion of moderate and severe patients was higher than that of the control group. The esophageal sphincter pressure in the observation group was significantly lower than that in the control group [(1.83±0.28) kPa vs. (3.42±0.34) kPa, P<0.05], and the orthostatic reflux time [(4.52±1.36)%], decubitus reflux time ratio [(4.83±1.27)%] and total reflux time [(3.49±1.02)%] in the observation group were significantly higher than those in the control group (P<0.05). The HAMA score (19.37±0.36) and HAMD score (17.73±0.83) in the observation group were significantly higher than those in the control group (P<0.05). In addition, the proportion of patients with normal nutrition in the observation group was significantly lower than that in the control group (19.23% vs. 51.47%), while the proportion of patients with underlying malnutrition was significantly higher than that in the control group (57.69% vs. 27.94%). Correlation analysis showed that DeMeester scores in the observation group were positively correlated with HAMA scores and HAMD scores (r=0.707 9 and 0.814 8, both P<0.000 1), and negatively correlated with MNA scores (r=-0.887 1, P<0.000 1).

Compared with GERD patients whose weight are in the normal range, those with obesity combined with GERD have a more severe condition, with a significant decrease in esophageal function and nutrient absorption, and more pronounced anxiety and depression, and the severity of their condition is significantly correlated with the degree of anxiety and depression and their nutritional status.