中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2011年
6期
316-319
,共4页
高炳霞%段丽萍%王琨%夏志伟
高炳霞%段麗萍%王琨%夏誌偉
고병하%단려평%왕곤%하지위
人体质量指数%胃食管反流病%食管裂孔疝%反流性食管炎%胃食管24 h pH监测
人體質量指數%胃食管反流病%食管裂孔疝%反流性食管炎%胃食管24 h pH鑑測
인체질량지수%위식관반류병%식관렬공산%반류성식관염%위식관24 h pH감측
Body mass index%Gastroesophageal reflux disease%Hiatal hernia%Reflux oesophagitis%24-hour pH monitoring
目的 探讨体质量指数(BMI)与食管裂孔疝(HH)及反流性食管炎(RE)的关系.方法 具有典型反酸、烧心等症状的227例胃食管反流病(GERD)患者,根据BMI(单位:kg/m2)将患者分为3组,正常组(18.5≤BMI<24)、超重组(24≤BMI<28)、肥胖组(BMI≥28).胃镜诊断RE、非糜烂性反流病(NERD)及HH.pH监测DeMeester积分≥15提示存在病理性酸反流.Logistic回归分析BMI与HH及RE的关系.结果 RE检出率为30.0%(68/227),HH检出率为5.7%(13/227);HH中76.9%(10/13) 存在RE.RE及HH检出率随BMI增加而升高(P均<0.05),且正常组、超重组和肥胖组中B级及以上RE所占比例也随BMI增加而升高(6.4%、16.9%、31.6%,P=0.003);pH监测DeMeester积分在上述3组分别为15.9、19.8和36.9,3组间差异有统计学意义(P<0.05),超重组患者下午、夜间及24 h食管内平均pH值均明显低于正常组(P均<0.01).多因素分析显示,肥胖是HH的危险因素,OR值为7.058(95%可信区间1.294～38.488,P=0.024).男性、超重、肥胖及HH是RE的危险因素,OR值分别为2.537(95%可信区间1.350～4.766,P=0.004)、1.921(95%可信区间1.005～3.670,P=0.048)、3.305(95%可信区间1.123～9.724,P=0.030)及6.879(95%可信区间1.695～27.913,P=0.007).结论 BMI与HH、RE及其严重程度显著相关,肥胖是HH及RE的共同危险因素,HH可促进RE的发生.
目的 探討體質量指數(BMI)與食管裂孔疝(HH)及反流性食管炎(RE)的關繫.方法 具有典型反痠、燒心等癥狀的227例胃食管反流病(GERD)患者,根據BMI(單位:kg/m2)將患者分為3組,正常組(18.5≤BMI<24)、超重組(24≤BMI<28)、肥胖組(BMI≥28).胃鏡診斷RE、非糜爛性反流病(NERD)及HH.pH鑑測DeMeester積分≥15提示存在病理性痠反流.Logistic迴歸分析BMI與HH及RE的關繫.結果 RE檢齣率為30.0%(68/227),HH檢齣率為5.7%(13/227);HH中76.9%(10/13) 存在RE.RE及HH檢齣率隨BMI增加而升高(P均<0.05),且正常組、超重組和肥胖組中B級及以上RE所佔比例也隨BMI增加而升高(6.4%、16.9%、31.6%,P=0.003);pH鑑測DeMeester積分在上述3組分彆為15.9、19.8和36.9,3組間差異有統計學意義(P<0.05),超重組患者下午、夜間及24 h食管內平均pH值均明顯低于正常組(P均<0.01).多因素分析顯示,肥胖是HH的危險因素,OR值為7.058(95%可信區間1.294～38.488,P=0.024).男性、超重、肥胖及HH是RE的危險因素,OR值分彆為2.537(95%可信區間1.350～4.766,P=0.004)、1.921(95%可信區間1.005～3.670,P=0.048)、3.305(95%可信區間1.123～9.724,P=0.030)及6.879(95%可信區間1.695～27.913,P=0.007).結論 BMI與HH、RE及其嚴重程度顯著相關,肥胖是HH及RE的共同危險因素,HH可促進RE的髮生.
목적 탐토체질량지수(BMI)여식관렬공산(HH)급반류성식관염(RE)적관계.방법 구유전형반산、소심등증상적227례위식관반류병(GERD)환자,근거BMI(단위:kg/m2)장환자분위3조,정상조(18.5≤BMI<24)、초중조(24≤BMI<28)、비반조(BMI≥28).위경진단RE、비미란성반류병(NERD)급HH.pH감측DeMeester적분≥15제시존재병이성산반류.Logistic회귀분석BMI여HH급RE적관계.결과 RE검출솔위30.0%(68/227),HH검출솔위5.7%(13/227);HH중76.9%(10/13) 존재RE.RE급HH검출솔수BMI증가이승고(P균<0.05),차정상조、초중조화비반조중B급급이상RE소점비례야수BMI증가이승고(6.4%、16.9%、31.6%,P=0.003);pH감측DeMeester적분재상술3조분별위15.9、19.8화36.9,3조간차이유통계학의의(P<0.05),초중조환자하오、야간급24 h식관내평균pH치균명현저우정상조(P균<0.01).다인소분석현시,비반시HH적위험인소,OR치위7.058(95%가신구간1.294～38.488,P=0.024).남성、초중、비반급HH시RE적위험인소,OR치분별위2.537(95%가신구간1.350～4.766,P=0.004)、1.921(95%가신구간1.005～3.670,P=0.048)、3.305(95%가신구간1.123～9.724,P=0.030)급6.879(95%가신구간1.695～27.913,P=0.007).결론 BMI여HH、RE급기엄중정도현저상관,비반시HH급RE적공동위험인소,HH가촉진RE적발생.
Objective To investigate the relationship of body mass index with hiatal hernia (HH) and reflux esophagitis (RE).Methods Two hundreds and twenty seven gastroesophageal reflux disease (GERD) patients with typical acid regurgitation and heartburn were enrolled and categorized into three groups according to body mass index (BMI, kg/m2) as normal weight (18.5≤BMI ＜24), overweight (24≤BMI＜28), and obesity (BMI≥28).RE, non-erosive reflux disease (NERD) and HH were diagnosed by gastroscopy.All the patients underwent ambulatory 24-hour pH monitoring and the pathological acid reflux was considered when the DeMeester score≥15.Effects of BMI on RE and HH were estimated by using logistic regression analysis.Results The percentages of RE and HH were 30.0%(68/227) and 5.7%(13/227), respectively.76.9% (10/13) HH patients had RE. Proportions of RE and HH increased significantly with increasing BMI (P＜0.05), so was that of RE above grade B in three groups (6.4%, 16.9% and 31.6%,P=0.003).DeMeester scores of the three groups were 15.9, 19.8 and 36.9, respectively (P＜0.05).The average 24-hour intra-esophagus pH value of overweight group, was significantly lower than that of normal weight patients in the afternoon and midnight (P＜0.01).Multivariate analysis showed obesity was a risk factor for HH with OR 7.058 (95% CI: 1.294～38.488, P=0.024), male (OR: 2.537, 95% CI: 1.350～4.766, P=0.004), overweight (OR: 1.921, 95% CI: 1.005～3.670, P=0.048), obesity (OR: 3.305, 95% CI: 1.123～9.724, P=0.030) and HH (OR: 6.879, 95% CI: 1.695～27.913, P=0.007) were risk factors for RE.Conclusion BMI has a significant association with HH and RE, obesity is a common risk factor for both HH and RE, HH may induce the development of RE.
