中国西北地区胃食管反流病患者临床特征的多中心研究  

Clinical characteristics of patients with gastro esophageal reflux disease in several centers of Northwest China

作　　者：高麦仓[1] 沈强[1] 王学红[2] 杨力[3] 周永宁[4] 张洪芳[2] 张蓉[1] 殷彩桥[1] 张军[1] 

机构地区：[1]西安交通大学第二附属医院消化科,西安710003 [2]青海大学附属医院消化科 [3]宁夏医科大学附属医院消化科 [4]兰州大学第一附属医院消化科

出　　处：《中华消化杂志》2013年第5期298-302,共5页Chinese Journal of Digestion

基　　金：国家卫生部临床学科重点基金（2007.353）

摘　　要：目的研究中国西北地区内镜中心胃食管反流病（GERD）患者的临床特征。方法2008年9月至2009年9月在西安、西宁、兰州、银川的4所医院内镜中心进行问卷调查。采用反流诊断问卷（RDQ）作为诊断依据，以症状程度和频度积分≥12分作为GERD初筛标准。从问卷确诊的GERD患者中随机抽取1／3患者，于齿状线下缘4个象限各取1块组织标本送病理组织学检查。资料输入EpiData3．0数据库，使用SPSS15．0进行统计学分析。结果获取合格问卷12454份，经RDQ共诊断GERD患者1246例，总体检出率为10．0％。425例GERD患者行活组织检查，其中齿状线上移距离〈3cm者占73．6％（313／425），齿状线上移距离≥3cm者占26．4％（112／425）；病理结果显示，正常食管黏膜占9．9％（42／425），慢性食管炎占80．2％（341／425），肠上皮化生占7．1％（30／425），低度不典型增生占1．9％（8／425），高度不典型增生和鳞状细胞癌均为0．2％（1／425），食管腺癌占0．4％（2／425）。GERD患者齿状线上移〈3cm和≥3cm者中，慢性食管炎、肠上皮化生、不典型增生及肿瘤的发生率分别为85．3％（267／313）、1．3％（4／313）、0．9％（3／313）、0和66．0％（74／112）、23．2％（26／112）、5．4％（6／112）、2．7％（3／112）。GERD发病与年龄、性别、BMI、吸烟、饮酒、食管裂孔疝及胆汁反流有密切关系。结论中国西北地区内镜中心就诊患者GERD临床检出率较高，年龄大、BMI高、吸烟、饮酒、胆汁反流和食管裂孔疝是其独立危险因素。齿状线上移距离≥3cm的GERD患者病弹前蛮糖严雷.Objective To investigate the clinical characteristics of gastro esophageal reflux disease （GERD） in several endoscopy centers of Northwest China. Methods From September 2008 to September 2009, a questionnaire survey was carried out in the endoscopy centers of four hospitals in Xi＇an, Xining, Lanzhou and Yinchuan. Reflux diagnostic questionnaire （RDQ） was used as diagnostic evidence. The score of symptom degree and frequency over 12 was considered as initial screening standard. One third GERD patients diagnosed by questionnaire were randomly selected. From each quadrant below the squamocolumnar junction （SCJ）, one specimen was taken for pathologic examination. All the data were input into database with EpiData 3.0 software and analyzed with SPSS 15.0 software. Results A total of 12 454 eligible questionnaires were collected, 1246 GERD patients were diagnosed according to RDQ, the total detection rate was 10.0%. A total of 425 cases received biopsy, the percentage of cases with upward shift of the SCJ less than 3 cm was 73.6% （313/425） and over 3 cm was 26.4% （112/425）. The pathologic results indicated the percentage of normal mucosa was 9. 9% （42/425）, chronic oesophagitis was 80. 20% （341/425）, intestinal metaplasia was 7.1% （30/425）, mild atypical hyperplasia was 1. 9% （8/425）, severe atypical hyperplasia and squamous cell carcinoma was 0. 2% （1/425） and adenocareinoma was 0. 4% （2/425）. Among the GERD patients with and upward shift of SCJ less than 3 cm and over 3 cm, the incidence of chronic inflammation, intestinal metaplasia, atypical hyperplasia and neoplasm was 85. 3% （267/313）, 1.3% （4/313）, 0.9% （3/313）, 0 and 66. 0% （74/112）, 23. 2% （26/112）, 5. 4% （6/112）, 2.7% （3/112） respectively. The pathogenesis of GERD was closely related with smoking, age, gender, body mass index （BMI）, alcohol intake, esophageal hiatal hernia and bile reflux. Conclusions The detection rate of GERD was high in Northwest China endoscopy centers. Age, BMI

关 键 词：西北地区 胃镜检查 胃食管反流 流行病学研究 

分 类 号：R571[医药卫生—消化系统]