反流性食管炎242例临床资料分析  

Reflux esophagitis:a clinical analysis of 242 cases

作　　者：王天佑[1] 毕春山[1] 姜佳丽[1] 王敏丽[1] 刘宾[1] 

机构地区：[1]首都医科大学附属北京同仁医院消化内科,北京市100730

出　　处：《世界华人消化杂志》2002年第8期942-945,共4页World Chinese Journal of Digestology

基　　金：北京市科委科研基金资助项目;No.954024700.~~

摘　　要：目的:通过分析反流性食管炎(RE)的内镜表现、24hpH值监测及幽门螺杆菌(Hp)检测,探讨RE的内镜特点和致病因素.方法:RE按洛杉矶分型标准进行分级,并注意观察是否并存食管裂孔疝及Barrett’s食管(BE)的内镜表现.60例RE患者进行24hpH值监测.156例RE进行快速尿素酶及病理银染色检测Hp感染.结果:A级98例,B级89例,C级33例,D级22例.A,B,C,D各级RE明显酸反流的发生率(64.7%,71.4%,62.5%,71.4%),均明显高于正常对照组(0%)(P<0.01);A,B,C,D各级RE合并食管裂孔疝者分别为:25.5%,30.7%、54.6%、60.9%,随RE病变加重合并食管裂孔疝者增多.合并BE者3例(1.2%),合并有不同程度的Barrett’s上皮改变者59例(24.4%).合并Hp感染者39.7%,显著低于胃溃疡组(70.7%)和十二指肠球溃疡组(80.7%)(P<0.01).结论:食管裂孔疝可能是RE的致病因素之一,且可能与RE的严重程度有关.酸反流是RE的致病因素之一.RE患者中Barrett’s现象并非罕见.Hp感染是否与RE的发病相关,有待更严格有效的流行病学调查的研究.AIM:To study the endoscopic characteristics and etiologyof reflux esophagitis (RE) by analyzing endoscopic repre-sentation and the ambulatory 24 h pH monitoring and in-fection of Helicobacter pylori (Hp).METHODS:The patients with RE were divided into differ-ent grades according to Los Angeles (LA) criteria and wereexamined for hiatus hernia and Barrett’s esophagus (BE).60 cases with RE received the ambulatory 24h pH monitoring.156 cases were detected for Hp by using rapid urease testand pathological silver staining.RESULTS: 242 cases with RE were divided into grade A(n =98), grade B (n =89), grade C (n =33), and grade D (n=22). The incidence of significant acid reflux of each groupswas 64.7%, 71.4%, 62.5%, and 71.4% respectively, whichwas higher than that in normal controls (0%, P <0.01). Theincidence of each group of patients associated with hiatushernia was 25.5%, 30.7%, 54.6%, and 60.9% respectivelyand the number of the cases associated with hiatus herniaincreased with the severity of RE. Among the patients withRE, the incidence of BE was 1.2% and Barrett’s epithelium ,24.4%. The rate of Hp infection in the RE group (39.7%)was significantly lower than that of gastric ulcer group (70.7%) and duodenal ulcer group (80.7%, P <0.01).CONCLUSIONS:Esophageal hiatus hernia may be onecause of RE and is correlated to the severity of RE. Acidreflux is one of etiological factors of RE. Barrett’s phenom-enon is not uncommon in RE patients. Further epidemio-logical study is warranted to confirm the association be-tween Hp infection and RE.

关 键 词：反流性食管炎 RE 致病因素 临床分析 内镜检查 

分 类 号：R571[医药卫生—消化系统]