老年反流性食管炎患者固体胃排空状况及其心理因素  

Solid gastric emptying and mental analysis in elderly patients with reflux esophagitis

作　　者：李军[1] 蔡昌豪[1] 吴本俨[1] 李园[1] 张建军 王金海 

机构地区：[1]中国人民解放军总医院南楼消化科,北京市100853 [2]总参北极寺干休处门诊部,北京市100083

出　　处：《世界华人消化杂志》2006年第35期3417-3420,共4页World Chinese Journal of Digestology

摘　　要：目的:老年反流性食管炎患者胃固体排空状况和相关因素分析,为临床诊治实践提供依据.方法:确诊为反流性食管炎的患者33例,采用13C辛酸呼气试验进行胃固体排空测定;1999年烟台会议制定的反流性食管炎分级标准进行内镜下分级;采用0-Ⅲ分法进行症状评分;Zung氏抑郁焦虑自评量表进行心理因素评估.结果:老年反流性食管炎患者胃半排空时间(halfgastricemptyingtime,T1/2)和延迟相时间(lagphasetime,Tlag)与对照组比较有显著性差异(147.5±19.3vs106.4±17.1,t=7.51,P<0.01;60.3±10.3vs34.2±9.2,t=9.42,P<0.01);病例组症状评分>6分组的T1/2和Tlag均高于<6分组(161.6±22.4vs137.6±16.7,t=4.01,P<0.01;71.8±11.8vs52.9±9.2,t=9.42,P<0.01);病例组中内镜分极Ⅰ级的患者其T1/2和Tlag与Ⅱ+Ⅲ组比较无显著差异;病例组抑郁和焦虑评分与对照组比较,有显著性差异(56.8±12.3vs39.6±9.8,P<0.01;53.4±10.9vs37.7±11.5,P<0.01).结论:老年反流性食管炎患者存在胃固体排空延迟,且延迟程度与症状评分有关,与内镜下分级无关;老年反流性食管炎患者普遍存在抑郁和焦虑情绪.AIM： To study the function of solid gastric emptying in elderly patients with reflux esophagitis （RE） and its correlative factors and provide evidence for clinical diagnosis and treatments. METHODS： The solid gastric emptying of RE patients （n = 33） was checked by ^13C-octanoic acid breath test. All the patients had been classified by endoscopy according the standard made on Yantai conference in 1999. The symptoms were scored and the mental factors were evaluated through Zung＇s self-rating depression scale. RESULTS： The half gastric emptying time （T1/2） and lag phase time （Tlag） in RE patients were both obviously higher than those in the controls （t = 7.51, P 〈 0.01; t = 9.42, P 〈 0.01）, and the values of T1/2 and Tlag in patients with more than 6 scores were also markedly higher than those with less than 6 scores （t = 4.01, P 〈 0.01; t = 9.42, P 〈 0.01）. However, no significant difference was found between endoscopic Ⅰ and Ⅱ ＋Ⅲ grade in T1/2 and Tlag. The melancholy and anxiety score in RE patients were significantly higher than those in the controls （56.8 ± 12.3 vs 39.6 ± 9.8, P 〈 0.01; 53.4 ± 10.9 vs 37.7 ± 11.5, P 〈 0.01）. CONCLUSION： The solid gastric emptying in elderly RE patients is significantly delayed, which is correlated with the symptom scores but not endoscopic grades. Melancholy and anxiety commonly exist in elderly RE patients.

关 键 词：反流性食管炎 胃排空 ^13C辛酸 Zung氏量表 

分 类 号：R571[医药卫生—消化系统]