前沿关注（32）：胃轻瘫的流行病学

（来源：Gastroenterology 2022;162:109–121 ）

背景及目的：尽管胃轻瘫造成了很大的卫生经济负担，但对于其流行病学却知之甚少。为提供胃轻瘫的真实世界的资料，本研究通过美国保险数据库调查了其流行情况、患者人口学资料及病因。

BACKGROUND & AIMS: Although gastroparesis carries a considerable health care and patient burden, associated epidemiological data are limited. To provide new real-world evidence for gastroparesis, we estimated disease prevalence, and investigated patient demographics and disease etiology in a large US claims database. 

方法：本回顾性横断面研究使用美国国家健康保险数据库资料，根据2018年美国人口普查区分年龄、性别及地理区域，针对人口学、临床变量及潜在的病因进行了描述性分析。

METHODS: This retrospective, cross-sectional analysis used de-identified, longitudinal patient-level enrollment and billing data for adults from the Optum Clin-formatics Data Mart database, a large US national administrative health insurance claims database. Prevalence was age-, sex-, and geographical region–standardized using the 2018 US census. Descriptive analyses of demographic and clinical variables and underlying disease etiologies were performed.

结果：胃轻瘫的总体标准化发病率为267.7/10万（95%CI：264.8–270.7），“确定的”胃轻瘫（症状超过3个月并在近3个月内通过胃排空闪烁扫描确诊）发生率为21.5 /10万 (95% CI 20.6–22.4)。共病指数评分为4.2，常见的共病为慢性肺病（46.4%），糖尿病慢性并发症（37.3%），外周血管疾病（30.4%）。病因最常见为糖尿病（57.4%），其次为术后（15.0%），药物诱发（11.8%），特发性（11.3%）。

RESULTS: The overall standardized prevalence of gastroparesis was 267.7 (95% confidence interval [CI] 264.8–270.7) per 100,000 US adults, whereas prevalence of “definite” gastroparesis (individuals diagnosed within 3 months of gastric emptying scintigraphy testing with persistent symptoms for more than 3 months) was 21.5 (95% CI 20.6–22.4) per 100,000 persons. Patients with gastroparesis had an overall Charlson Comorbidity Index score of 4.2, indicating substantial comorbidity burden. The most frequently documented comorbidities were chronic pulmonary disease (46.4%), diabetes with chronic complication (37.3%), and peripheral vascular disease (30.4%). Patients most commonly had a diabetic etiology (57.4%; type 1, 5.7% and type 2, 51.7%), followed by postsurgical (15.0%), drug-induced (11.8%), and idiopathic (11.3%) etiologies. 

结论：本研究提供了美国总体人群的胃轻瘫流行情况、人口学及病因的数据。更客观可靠的胃排空测定方法，以及专业教育有助于进一步提高对本病的研究及理解。

CONCLUSIONS: New evidence is provided regarding the prevalence, patient demographics, and etiology of gastroparesis in the US general population. Wider availability of reliable objective gastric emptying measures and further education of medical professionals in recognizing and diagnosing gastroparesis would benefit future studies and improve understanding of disease epidemiology.

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