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目的 通过研究 10年间内镜所诊断的反流性食管炎 (RE)病例 ,探讨中国人RE的内镜和临床特点。方法 1990至 1999年胃镜诊断的 182 7例RE患者 ,按洛杉矶标准及中国试行标准进行分级 ,部分患者还进行食管运动功能检查。分析患者年龄、性别、症状、伴发疾病及与各项检查的关系。结果 RE占总胃镜检查人数的 2 .0 2 % ,男女之比为 3.9∶1。平均年龄 (5 2 .0 2± 14.38)岁 ,5 8.6 2 %的原发性RE超过 5 0岁。仅 36 .2 9%有典型的反流症状。RE以中、轻度者 (洛杉矶标准的A、B级或烟台标准Ⅰ级 )多见 ,近 80 % ,重度少见。RE患者的平均pH <4总时间百分比及平均胆红素吸收值>0 .14总时间百分比均显著高于正常 (P <0 .0 1) ,重度RE显著高于轻度 (P <0 .0 5 ) ,而平均下食管括约肌压与正常相比差异无显著性 (P >0 .0 5 )。结论 中国人RE患病率较西方国家低 ,以男性老年人多见 ,程度多较轻 ,与胃及十二指肠内容物反流均有密切关系。仅依据反流症状来诊断RE的敏感性较低 ,内镜对RE的诊断具有重要意义
Objective To investigate the endoscopic and clinical features of Chinese RE by studying the cases of reflux esophagitis (RE) diagnosed by endoscopy in 10 years. Methods A total of 182 7 RE patients diagnosed by gastroscopy from 1990 to 1999 were classified according to the standards of Los Angeles and Chinese pilot. Some patients also had esophageal motor function tests. Analysis of patient age, gender, symptoms, associated with disease and the relationship between the various tests. Results RE accounted for 2.02% of the total number of gastroscopy, the ratio of men to women was 3.9: 1. The mean age (52.02 ± 14.38) years and 5 8.6% of the primary REs were over 50 years old. Only 36.29% had typical reflux symptoms. RE is moderate and mild (Los Angeles standards A, B or Yantai standard Ⅰ grade) more common, nearly 80%, severe rare. RE patients had an average pH <4% of total time and an average bilirubin absorption> 0.14% of total time were significantly higher than normal (P <0.01), severe RE was significantly higher than mild (P <0. 0 5). However, the mean esophageal sphincter pressure was not significantly different from the normal one (P> 0.05). Conclusion The prevalence of RE in Chinese is lower than that in Western countries. The prevalence of RE in Chinese is more common and lower than that of male. It is closely related to the reflux of gastric and duodenal contents. It is less sensitive to diagnose RE based on reflux symptoms only, and endoscopy is of great significance for the diagnosis of RE