反流性食管炎和消化性溃疡关系的探讨  

Relationship between reflux esophagitis and peptic ulcer

作　　者：陈龙根[1] 董来华[1] 葛建荣[1] 张黎[1] 马君红[1] 茅育蕾[1] 

机构地区：[1]绍兴文理学院医学院附属医院消化内科,浙江绍兴312000

出　　处：《医师进修杂志》2004年第6期27-28,共2页Journal of Postgraduates of Medicine

摘　　要：目的　通过反流性食管炎有无合并消化性溃疡病例的分析 ,探讨消化性溃疡 (PU)对反流性食管炎 (RE)的影响及其机制。方法　收集 9年间胃镜诊断的 75 6例原发性RE ,分为两组 ,一组合并消化性溃疡 (RE +PU) 6 9例 ,另一组未合并消化性溃疡 6 87例 (RE -PU) ,对两组胃窦黏膜 (75 6例 )和食管下段黏膜 (1 74例 )的组织学和幽门螺杆菌(Hp)感染情况进行分析。RE按中国烟台试行标准进行分级。结果　RE +PU组患者的平均年龄 (4 6 .33± 1 3.1 4 )岁 ,显著较RE -PU组 (4 2 .90± 1 3.6 8)岁为高 (P <0 .0 5 )。RE +PU组患者Ⅱ、Ⅲ级RE 2 5例 (2 5 / 6 9,36 .2 3% ) ,与RE-PU组 (1 2 4 / 6 87,1 8.0 5 % )比较差异显著 (P <0 .0 1 )。RE +PU组的胃窦黏膜Hp阳性率 (70 .5 9% )也较RE -PU组(4 3.6 2 % )为高 (P <0 .0 1 )。RE +PU组的食管下段黏膜Hp阳性率为 2 6 .92 % ,较RE -PU组 (1 0 .81 % )显著为高(P <0 .0 5 )。此外 ,1 74例Ⅰ、Ⅱ、Ⅲ级RE的食管下段黏膜Hp阳性率分别为 0、8.5 7%、39.5 3% ,三者间差异显著 (P<0 .0 1 )。结论　合并消化性溃疡的反流性食管炎患者年龄较大 ,胃窦黏膜Hp阳性率较高 ,食管下段黏膜病变程度较重 。Objective To study effects and mechanism of peptic ulcer(PU) on reflux esophagitis(RE).Methods\ 756 cases of primary RE were divided into two group,69 cases of reflux esophagitis with peptic ulcer(RE+PU),another group included 687 cases with reflux esophagitis without peptic ulcer(RE-PU). Histological examination and helicobacter pylori (Hp) positive rate of mucous membrane of gastric pylorus(756 cases) and lower segment of esophagus(174 cases) in two groups were analysed.Results Rate of grade Ⅱ and Ⅲ of RE in the RE+PU group (25/69,36.23%)was significantly difference than RE-PU group (124/687,18.05%,P<0.01). Hp positive rate of mucous membrane of gastric pylorus in RE+PU group(70.59%) was significantly higher than RE-PU group(43.62%,P<0.01).Hp positive rate of lower segment of esophagus in 174 cases of RE were 0, 8.57% and 39.53% in grade Ⅰ,Ⅱ and Ⅲ,respectively. Also there were significantly difference in three grades(P<0.01). Conclusion Compared with RE-PU group, RE+PU group is year older, Hp positive rate of mucous membrane of gastric pylorus is higher ,with more severe lesions of lower segment of esophagus.

关 键 词：反流性食管炎 消化性溃疡 幽门螺杆菌 

分 类 号：R573.1[医药卫生—消化系统]