CAJ | 학술논문

目的罗马Ⅲ标准提出了非糜烂性反流病(NERD)和功能性烧心(FH)的诊断标准.根据该标准,结合胃镜、食管pH监测及质子泵抑制剂(PPI)试验,探讨烧心患者临床类型及特征.方法 62例连续就诊的烧心患者填写症状问卷后全部行内镜检查,对内镜阴性的患者进行24 h食管pH监测,计算症状指数(SI),随后全部患者完成PPI试验(埃索美拉唑20 mg,每天2次,14 d).结果反流性食管炎(RE)16例,NERD和FH分别为39例、7例;NERD又可分3个亚型,pH监测正常的NERD与FH仍存在多项参数的差异;内镜阴性患者中PPI试验阳性组与阴性组的pH监测值比较差异无统计学意义(χ2=2.681,P=0.102).结论烧心患者可分为RE、NERD和FH三类,NERD和FH是临床特点不同的异质性疾病.
목적 라마Ⅲ표준제출료비미란성반류병(NERD)화공능성소심(FH)적진단표준.근거해표준,결합위경、식관pH감측급질자빙억제제(PPI)시험,탐토소심환자림상류형급특정.방법 62례련속취진적소심환자전사증상문권후전부행내경검사,대내경음성적환자진행24 h식관pH감측,계산증상지수(SI),수후전부환자완성PPI시험(애색미랍서20 mg,매천2차,14 d).결과 반류성식관염(RE)16례,NERD화FH분별위39례、7례;NERD우가분3개아형,pH감측정상적NERD여FH잉존재다항삼수적차이;내경음성환자중PPI시험양성조여음성조적pH감측치비교차이무통계학의의(χ2=2.681,P=0.102).결론 소심환자가분위RE、NERD화FH삼류,NERD화FH시림상특점불동적이질성질병.
Objective To study the classification and characteristics of heartburn patients based on endoscopy, 24 hours esophageal pH monitoring and PPI trial according to Roma M criteria. Methods Consecutive patients with frequent heartburn were enrolled and required to fill out a questionnaire. An upper gastrointestinal endoscopy was performed for each patient and those having a normal endoscopy were followed by 24 hours esophageal pH monitoring with calculated symptom index. Finally, all patients were administrated with PPI (esomeprazole 20 mg twice daily, 14 days). Results Sixty -two patients were enrolled and composed by RE (16 cases) , NERD (39 cases) and FH(7 cases) and NERD were divided into 3 subgroups. Among all patients with normal 24 hours pH monitoring, significant differences were seen in several parameters between NERD patients and FH patients; No significant difference was found in acid exposure time between patients with positive PPI trial and those negative (χ2 = 2. 681, P = 0. 102). Conclusions Heartburn patients can be classified into RE, NERD and FH according to Roma Ⅲ criteria. NERD and FH are heterogeneous disease with distinct clinical characteristics.