非糜烂性反流病和反流性食管炎患者的临床特征和食管动力与反流特点分析  

Analysis of clinical data, esophageal motility and reflux characteristics in patients with non-erosive reflux disease（NERD） and reflux esophagitis（RE）

作　　者：王慧芬[1] 刘芳[1] 王淼[1] 杜时雨[1] 张艳丽[1] Wang Huifen;Liu Fang;Wang Miao;Du Shiyu;Zhang Yanli(Department of Gastroenterology, China-Japan Friendship Hospital,Belting 100029, China)

机构地区：[1]中日友好医院消化内科,北京100029

出　　处：《中华医学杂志》2018年第20期1605-1608,共4页National Medical Journal of China

摘　　要：目的比较非糜烂性反流病（NERD）和反流性食管炎（RE）患者的临床特征和食管动力学与反流特点。方法本研究纳入非糜烂性反流病（NERD）患者167例[男60例，女107例，年龄（44．1±13．4）岁]，反流性食管炎（RE）患者151例[男74例，女77例，年龄（46．5±9．9）岁]。通过问卷调查了解患者的症状特点及上述相关因素，通过食管测压及24h pH＋阻抗监测了解患者的食管动力学及反流情况。结果NERD组女性患者比例高于RE组（60／107比74／77，P=0．049）；NERD组反食症状评分和反食症状发生率均低于RE组[（4．5±2．4）比（5．6±2．1），44．91％比64．24％，均P〈0．05]；NERD组的Demeester评分显著低于RE组[12．54（1．60，10．80）比17．31（3．40，16．64），P=0．044]，且NERD组Demeester评分阳性患者所占的比例低于RE组（15．1％比23．8％，P=0．018）。NERD组的酸反流次数低于RE组[17．49（3．00，22．22）比21．69（4．00，30．00），P=0．042]。结论NERD患者女性比例更高，且反食症状较RE患者轻，RE患者以酸反流事件为主，两组的食管动力学指标未见明显差异。Objective To compare the clinical data, esophageal motility and reflux characteristic in patients with non-erosive reflux disease （NERD） and reflux esophagitis （RE）. Methods A total of 167 patients of NERD were enrolled in the study [ 60 males, 107 females, mean age （44. 1 ±13.4 ） years old ], and 151 patients of RE were enrolled [ 74 males ,77 females, mean age （46. 5 ± 9. 9 ） years old ]. All patients were surveyed by questionnaires to investigate the clinical data. All patients accepted the esophageal highresolution manometry and 24 hours pH ＋ impedance monitoring to investigate the esophageal motility and reflux characteristic. Results The proportion of female patients in group NERD was significantly higher than that in group RE （60/107 vs 74/77, P =0. 049）. The reflux symptom scores and the proportion of reflux in group NERD were significantly lower than those in group RE[ （4. 5 ±2. 4） vs （5.6 ±2. 1 ）, 44. 91% vs 64. 24%, P 〈 0. 05 ）. The Demeester score of group NERD was significantly lower than that of group RE [ 12. 54 （ 1.60,10. 80） vs 17.31 （3.40,16. 64） , P = 0. 0441. The proportion of Demeester scores positive patients in group NERD was significantly lower than that in group RE（ 15. 1% vs 23.8% ,P =0. 018）. The number of acid reflux in group NERD was significantly lower than that in group RE [ 17.49 （3.00,22. 22 ） vs 21.69（4. 00,30. 00）, P = 0. 0421. Conclusions There are more female patients in group NERD. The reflux symptoms of the group NERD are less serious than those of group RE. RE patients have more acid reflux events. There is no significant difference in the esophageal motility between the two groups.

关 键 词：胃食管反流 临床特点 高分辨食管测压 食管反流监测 

分 类 号：R571[医药卫生—消化系统]