3956例反流性食管炎临床特征分析  

Analysis of clinical characteristics of reflux esophagitis in 3956 patients

作　　者：王赜煜[1] 李倩[1] 李熳[1] 张静[1] 白露[1] 张志广[1] 

机构地区：[1]天津医科大学第二医院消化内科,天津300211

出　　处：《天津医科大学学报》2017年第1期65-67,共3页Journal of Tianjin Medical University

摘　　要：目的:探讨3 956例不同洛杉矶分型的反流性食管炎(RE)患者中RE分级与年龄、性别、幽门螺杆菌(HP)感染及伴发疾病的关系。方法:收集胃镜确诊RE的3 956例患者资料,按洛杉矶标准进行分级并进一步分析。结果:患者的RE分级构成在不同年龄及性别中均有明显差异(P<0.001),男性和中老年患者的LA-B和LA-C的比例明显高。RE伴有消化性溃疡、胃/食管息肉的分级构成与总的RE患者的分级构成相比无明显差异,但食管裂孔疝有明显差异。1 366例行HP呼气试验检查的RE患者中HP阳性率为47.3%,低于慢性胃炎对照组。RE伴消化性溃疡患者中十二指肠球溃疡的比例(73.8%)明显高于慢性胃炎对照组。结论:男性、中老年患者及伴有食管裂孔疝的患者RE分级中LA-B和LA-C的比例更高,HP阳性率与食管炎负相关,RE患者更易伴发十二指肠球溃疡。Objective： To discuss whether the grades of reflux esophagitis （RE） according to Los Angeles （LA） criteria are associated with the age, sex, helicobacter pylori （HP） infection and accompanied diseases. Methods： The data of 3 956 patients with reflux esophagitis were collected. They were divided into different grades according to Los Angeles System. The relationship between the grades and age, sex, HP infection and accompanied disease was analyzed. Results： There were significant differences in grade constitution among different stage of age and between different sexes （P〈0.001）. The proportions of LA-B and LA-C in male patients and older patients were significantly higher. There was no difference in the grade constitution between RE accompanied peptic ulcer and gastric/esophageal polyps and in all RE patients. But the difference among the patients accompanied hiatal hernia was significant. The HP positive rate in the 1 366 RE patients who were underwent 13C/14C-urea breath test was 47.3%. This positive rate was lower than that of chronic gastritis group. The proportion of duodenal ulcer in RE patients was significantly higher than in chronic gastritis group （73.8% vs 58.6%）. Conclusion： The proportions of LA-B 和 LA-C in male patients, older patients and the patients accompanied hiatal hernia are significantly higher than female patients, younger patients and the patients accompanied peptic ulcer and gastric/esophageal polyps. The HP positive rate in RE patients has a negative correlation with esophagitis. The RE patients are more vulnerable to duodenal ulcer.

关 键 词：食管炎 溃疡 息肉 食管裂孔疝 幽门螺杆菌 

分 类 号：R571[医药卫生—消化系统]