中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2012年
7期
515-518
,共4页
裴艳香%尚占民%郝建宇%黄皖农
裴豔香%尚佔民%郝建宇%黃皖農
배염향%상점민%학건우%황환농
胃食管反流%食管pH监测%回顾性研究
胃食管反流%食管pH鑑測%迴顧性研究
위식관반류%식관pH감측%회고성연구
Gastroesophageal reflux%Esophageal pH Monitoring%Retrospective studies
目的 分析老年胃食管反流病(GERD)患者的临床特征、食管动力学及酸暴露的特点,为临床诊断及治疗提供帮助.方法 回顾分析2005至2011年我院门诊完成所有检查并确诊的260例GERD患者资料,将其分为老年组(≥60岁)与中青年组(＜60岁),分析两组患者的食管炎发生率、严重程度以及食管动力学、酸暴露情况.结果 老年组GERD患者食管裂孔疝、不典型反流症状及食管外症状的发生率明显高于中青年组(分别为45.1％、36.3％、37.1％与30.6％、27.2％、25.2％),两组间差异有统计学意义(P值分别为0.016、0.005、0.037).两组患者内镜下食管炎发生率差异无统计学意义(分别为57.5％与50.3％,P=0.250),但老年组患者中重度食管炎发生率高于中青年患者(B级及C+D级食管炎发生率分别为19.5％、8.8％与10.2％、2.7％,P值分别为0.034、0.030).老年组患者的立卧位酸清除时间、立卧位反流时间百分比及反流指数DeMeester积分均高于中青年组,且立位酸清除时间百分比、卧位反流时间百分比及DeMeester积分之间差异有统计学意义(P值分别为0.000、0.006、0.001).老年组下食管括约肌压力、食管体部蠕动波幅均低于中青年组,非传导性收缩百分比高于中青年组,两组间下食管括约肌压力差异有统计学意义(分别为13.36±6.39,15.57±7.01,P=0.009).结论 与中青年GERD相比,老年GERD患者食管动力功能下降,酸暴露时间延长,中重度食管炎发生率增加.
目的 分析老年胃食管反流病(GERD)患者的臨床特徵、食管動力學及痠暴露的特點,為臨床診斷及治療提供幫助.方法 迴顧分析2005至2011年我院門診完成所有檢查併確診的260例GERD患者資料,將其分為老年組(≥60歲)與中青年組(＜60歲),分析兩組患者的食管炎髮生率、嚴重程度以及食管動力學、痠暴露情況.結果 老年組GERD患者食管裂孔疝、不典型反流癥狀及食管外癥狀的髮生率明顯高于中青年組(分彆為45.1％、36.3％、37.1％與30.6％、27.2％、25.2％),兩組間差異有統計學意義(P值分彆為0.016、0.005、0.037).兩組患者內鏡下食管炎髮生率差異無統計學意義(分彆為57.5％與50.3％,P=0.250),但老年組患者中重度食管炎髮生率高于中青年患者(B級及C+D級食管炎髮生率分彆為19.5％、8.8％與10.2％、2.7％,P值分彆為0.034、0.030).老年組患者的立臥位痠清除時間、立臥位反流時間百分比及反流指數DeMeester積分均高于中青年組,且立位痠清除時間百分比、臥位反流時間百分比及DeMeester積分之間差異有統計學意義(P值分彆為0.000、0.006、0.001).老年組下食管括約肌壓力、食管體部蠕動波幅均低于中青年組,非傳導性收縮百分比高于中青年組,兩組間下食管括約肌壓力差異有統計學意義(分彆為13.36±6.39,15.57±7.01,P=0.009).結論 與中青年GERD相比,老年GERD患者食管動力功能下降,痠暴露時間延長,中重度食管炎髮生率增加.
목적 분석노년위식관반류병(GERD)환자적림상특정、식관동역학급산폭로적특점,위림상진단급치료제공방조.방법 회고분석2005지2011년아원문진완성소유검사병학진적260례GERD환자자료,장기분위노년조(≥60세)여중청년조(＜60세),분석량조환자적식관염발생솔、엄중정도이급식관동역학、산폭로정황.결과 노년조GERD환자식관렬공산、불전형반류증상급식관외증상적발생솔명현고우중청년조(분별위45.1％、36.3％、37.1％여30.6％、27.2％、25.2％),량조간차이유통계학의의(P치분별위0.016、0.005、0.037).량조환자내경하식관염발생솔차이무통계학의의(분별위57.5％여50.3％,P=0.250),단노년조환자중중도식관염발생솔고우중청년환자(B급급C+D급식관염발생솔분별위19.5％、8.8％여10.2％、2.7％,P치분별위0.034、0.030).노년조환자적립와위산청제시간、립와위반류시간백분비급반류지수DeMeester적분균고우중청년조,차립위산청제시간백분비、와위반류시간백분비급DeMeester적분지간차이유통계학의의(P치분별위0.000、0.006、0.001).노년조하식관괄약기압력、식관체부연동파폭균저우중청년조,비전도성수축백분비고우중청년조,량조간하식관괄약기압력차이유통계학의의(분별위13.36±6.39,15.57±7.01,P=0.009).결론 여중청년GERD상비,노년GERD환자식관동력공능하강,산폭로시간연장,중중도식관염발생솔증가.
Objectlve To review the clinical characteristics,esophageal motility and acid exposure in elderly patients with gastroesophageal reflux disease (GERD).Methods Two hundred and sixty patients aged 18 -81 years were diagnosed as gastroesophageal reflux disease from 2005 to 2011 in outpatient clinic,the patients were divided into elderly group ( ≥ 60 y) and control group ( ＜ 60 y).The incidence of esophagitis,severity of esophagitis,esophageal motility and esophageal acid exposure were analyzed and compared between two groups.Results The incidence of esophageal hiatal hernia,non-typical reflux symptoms and extra-esophageal symptoms in elderly group were higher than that of control group(45.1％ vs.30.6％,36.3％ vs.27.2％ and 37.1％ vs.25.2％,P =0.016,0.005 and 0.037,respectively).There was no significant difference in esophagitis incidence between two group (55.8％ vs.50.3％,P =0.250).The incidence of esophagitis graded as LA-B to LA-D were higher in elderly group( 19.5％ vs.10.2％ and 8.8％ vs.2.7％,P =0.034 and 0.030,respectively).The percentage of upright acid clearance time,supine reflux time of pH ＜4 and the DeMeester score of elderly group were higher than those of control group (P =0.000,0.006 and 0.001,respectively).Lower esophageal sphincter pressure (LESP) of elderly group was lower than that of control group ( 13.36 ±6.39 vs.15.57 ±7.01,P =0.009).Conclusion In comparison with young and middle-aged patients,the elderly GERD patients have lower esophageal motility,longer esophageal acid exposure time and higher frequency of severer esophagitis.
