烧心患者的临床类型及特征分析  

Clinical classification and characteristics of consecutive patients with frequent heartburn

作　　者：史一楠[1] 熊理守[1] 林金坤[1] 陈旻湖[1] 

机构地区：[1]中山大学附属第一医院消化内科,广州510080

出　　处：《中国实用医刊》2011年第2期34-37,共4页Chinese Journal of Practical Medicine

摘　　要：目的罗马Ⅲ标准提出了非糜烂性反流病（NERD）和功能性烧心（FH）的诊断标准。根据该标准，结合胃镜、食管pH监测及质子泵抑制剂（PPI）试验，探讨烧心患者临床类型及特征。方法62例连续就诊的烧心患者填写症状问卷后全部行内镜检查，对内镜阴性的患者进行24h食管pH监测，计算症状指数（sI），随后全部患者完成PPI试验（埃索美拉唑20mg，每天2次，14d）：结果反流性食管炎（RE）16例，NERD和FH分别为39例、7例；NERD又可分3个亚型，pH监测正常的NERD与FH仍存在多项参数的差异：内镜阴性患者中PPI试验阳性组与阴性纽的pH监测值比较差异无统计学意义（x2=2．681，P=0．102）。结论烧心患者可分为RE、NERD和FH三类，NERD和FH是临床特点不同的异质性疾病。Objective To study the classification and characteristics of heartburn patients based on endoscopy, 24 hours esophageal pH monitoring and PPI trial according to Roma III criteria. Methods Con- secutive patients with frequent heartburn were enrolled and required to fill out a questionnaire. An upper gastrointestinal endoscopy was performed for each patient and those having a normal endoscopy were followed by 24 hours esophageal pH monitoring with calculated symptom index. Finally, all patients were administrated with PPI （esomeprazole 20 mg twice daily, 14 days）. Results Sixty - two patients were enrolled and composed by RE （16 cases） , NERD （39 cases） and FH（7 cases） and NERD were divided into 3 subgroups. Among all patients with normal 24 hours pH monitoring, significant differences were seen in several parameters between NERD patients and FH patients; No significant difference was found in acid exposure time between patients with positive PPI trial and those negative （X2= 2. 681, P = 0. 102）. Conclusions Heartburn patients can be classified into RE, NERD and FH according to Roma III criteria. NERD and FH are heterogeneous disease with distinct clinical characteristics.

关 键 词：烧心 非糜烂性反流病 功能性烧心 

分 类 号：R571[医药卫生—消化系统]