【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(GEFVⅠ和Ⅱ级,共229例)和异常组(GEFVⅢ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(P<0.05)。与GEFV正常组比较,GEFV异常组的吸烟、饮酒者比例明显增高,HH比例高(P<0.05)、重度食管炎比例高,且反酸、胃部烧灼感症状程度较重,奥美拉唑疗效较差(P<0.05)。两组的年龄、BMI、Hp阳性率、生活质量及焦虑抑郁评分差异均无统计学意义(P>0.05)。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。更多还原

【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 andⅣ 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(P<0.05).Cmpared with GEFV normal group,the proportion of smoking and drinking increased significantly,the proportion of HH and severe esophagitis were high,the degree of acid reflux,stomach burning sensation symptom were more severe,and the efficacy of Omeprazole was poorer.poor curative effect of omeprazole(P<0.05).There was no statistical difference of age,BMI,Hp positive rate,quality of life and anxiety and depression score between the two groups(P>0.05).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.更多还原