反流性食管炎内镜诊断及其相关因素分析  

Endoscopic profiles of reflux esophagitis and its related factors

作　　者：胡景[1] 杨云生[1] 孙刚[1] 彭丽华[1] 黄启阳[1] 孙国辉[1] 蔡逢春[1] 令狐恩强[1] 

机构地区：[1]解放军总医院消化科,北京100853

出　　处：《胃肠病学和肝病学杂志》2007年第3期205-208,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨反流性食管炎（RE）的镜下特征及相关因素的关系。方法分析2003年1月～2005年12月我院内镜诊断的反流性食管炎1588例,食管炎分级按洛杉矶标准,探讨其与性别、年龄、镜下表现、食管狭窄、食管不典型增生等相关因素的关系。结果①3年内RE（均为内镜阳性RE）占同期内镜总检查例次的4.39%。其中A级占34.13%（542/1588）、B级占56.05%（890/1588）、C级占7.05%（112/1588）、D级占2.77%（44/1588）。②男女比例为3.51∶1。男性发病年龄平均53.63±14.98岁,女性平均56.49±14.98岁（P=0.01）;50岁以下占43.64%,50岁以上占56.36%,50岁以上患者发病率明显增多（P=0.000）。③镜下表现为溃疡者3.53%（56/1588）,糜烂96.47%（1532/1588）,食管狭窄占1.13%（18/1588）,食管不典型增生占0.88%（14/1588）。溃疡、食管狭窄和食管不典型增生与RE分级密切相关,从A级到D级,溃疡、食管狭窄和不典型增生的比例逐渐升高,分别是1.29%、2.92%、9.82%、27.27%（P=0.000）;0.37%、0.67%、4.46%、11.4%（P=0.000）和0.37%、0.9%、1.79%、4.55%（P=0.02）。④RE严重程度与年龄无关（P=0.103）。结论内镜诊断的RE,中国人A、B级多见,且男性多于女性。高龄（50岁以上）患者RE比例明显增多。食管溃疡、食管狭窄、食管不典型增生与RE分级严重程度呈正比。Objective To investigate the related factors of the reflux esophagitis（RE）. Methods We retrospectively analyzed the endoscopic findings of 1 588 RE cases diagnosed endoscpy from January 2003 to December 2005. RE was defined according to the four-level scale of the Los Angeles classification system. We investigated the relations between esophagitis and gender, age, endoscopic characteristics, esophageal stricture and esophageal atypical hyperplasia. Results The occurrence of RE was 4.39% in all the subjects. The frequencies of from A to D level were 34. 13% （542/1 588） ,56.05% （890/1 588）, 7.05% （112/1 588）, and 2.77% （44/1 588） respectively. The gender ratio of male versus female was 3.51 ： 1, the mean onset age was 53.63 ± 14.98 yrs in male compared to 56.49 ±14.98 yrs in female（P = 0.01 ） ; patients less than 50 years accounted for 43.64% while patients more than 50 years accounted for 53.36% （P = 0. 000）. In this study, 3.53% of patients were found with ulcer （56/1 588）, 96.47% with erosion （1 532/1 588）, 1. 13% with esophageal stricture （18/1 588）,and 0.88% with atypical hyperplasia （14/1 588）. From A to D level, the ratio of ulcer occurrence, stricture and atypical hyperplasia increased gradually, and they 1.29% , 2.92%,9.82%,27.27% （P=0.000）;0.37%,0.67%,4.46%,11.4% （P=0.000）; 0.37%,0.9%,1.79%, 4.55% （P = 0.02）. The severity of RE had no relation with age （P = 0. 103 ）. Conclusion A and B-level of RE patients are more common in Chinese population, and the male patients are more than the female. The prevalence is significantly increased among the patients older than 50. Esophageal ulcer, esophageal stricture, atypical hyperplasia show a positive relation with the classification of RE

关 键 词：反流性食管炎 内镜分级 相关因素 

分 类 号：R571[医药卫生—消化系统]