胃食管阀瓣异常反流性食管炎患者临床特征分析.docVIP

胃食管阀瓣异常反流性食管炎患者临床特征分析 　　[摘要]目的 分析胃食管阀瓣（GEFV）异常的反流性食管炎（RE）患者的临床特征，为RE的诊治提供参考。方法 收集2011年7月～2012年4月在我院消化科行胃镜检查的RE患者，将RE患者分为GEFV正常组（GEFV Ⅰ和Ⅱ级，共229例）和异常组（GEFV Ⅲ和Ⅳ级，共103例），通过问卷调查和质子泵抑制剂（PPI）治疗后随访，比较两组患者的食管炎程度（LA标准）、食管裂孔疝（HH）、Hp阳性率、年龄、性别、BMI、饮食和生活习惯、临床症状、生活质量、焦虑抑郁评分、奥美拉唑疗效等。结果 GEFV异常组的男性患者比例高于GEFV正常组（P0.05）。 结论 GEFV异常的RE患者的重度食管炎及HH患病率明显升高，反流症状更严重，PPI疗效差。吸烟、饮酒等不良生活习惯可能与GEFV异常有关。 　　[关键词]反流性食管炎；胃食管阀瓣；质子泵抑制剂治疗；生活质量 　　[中图分类号] R571 [文献标识码] A [文章编号] 1674-4721（2017）12（b）-0019-04 　　[Abstract]Objective To analyze the clinical features of patients with reflux esophagitis （RE） with abnormal gastroesophageal flap valve （GEFV） to provide the reference for the diagnosis and treatment of reflux esophagitis.Methods Patients with RE given gastroscopy in gastroenterology department of our hospital from July 2011 to April 2012 were collected and they were divided into GEFV normal group （grade Ⅰand Ⅱ of GEFV，n=229） and GEFV abnormal group （grade Ⅲ and Ⅳ of GEFV，n=103）.Patients were followed-up by questionnaire survey and after proton pump inhibitor （PPI） treatment，the degree of esophagitis （LA standard），hiatal hernia （HH），Hp positive rate，age，gender，BMI，diet and lifestyle，clinical symptoms，quality of life，anxiety and depression score，the efficacy of Omeprazole and so on in patients between the two groups were compared.Results The proportion of male patients in GEFV abnormal group was higher than that in GEFV normal group （P0.05）.Conclusion The prevalence rate of severe esophagitis and HH are significantly are significantly increased，the reflux symptoms are more severe，and PPI has poor curative effect.Bad habits such as smoking and drinking may be associated with GEFV abnormalities. 　　[Key words]Reflux esophagitis；Gastroesophageal flap valve；PPI treatment；Quality of life 　　胃食管反流病（gastroesophageal reflux disease，GERD）是由胃?热菸锓戳饕?起不适症状和（或）并发症的一种疾病[1]，包括非糜烂性反流病（non-erosive reflux disease，NERD）、反流性食管炎（reflux esophagitis，RE）以及Barrett食管（Barrett esophagus，BE）。近年来，GERD在亚洲的发病率逐年上升。RE的机制包括食管抗反流屏障异常、