CAJ | 학술논문

目的研究中国西北地区内镜中心胃食管反流病(GERD)患者的临床特征.方法 2008年9月至2009年9月在西安、西宁、兰州、银川的4所医院内镜中心进行问卷调查.采用反流诊断问卷(RDQ)作为诊断依据,以症状程度和频度积分≥12分作为GERD初筛标准.从问卷确诊的GERD患者中随机抽取1/3患者,于齿状线下缘4个象限各取1块组织标本送病理组织学检查.资料输入EpiData 3.0数据库,使用SPSS 15.0进行统计学分析.结果获取合格问卷12 454份,经RDQ共诊断GERD患者1246例,总体检出率为10.0％.425例GERD患者行活组织检查,其中齿状线上移距离＜3 cm者占73.6％ (313/425),齿状线上移距离≥3 cm者占26.4％ (112/425)；病理结果显示,正常食管黏膜占9.9％(42/425),慢性食管炎占80.2％ (341/425),肠上皮化生占7.1％(30/425),低度不典型增生占1.9％(8/425),高度不典型增生和鳞状细胞癌均为0.2％(1/425),食管腺癌占0.4％ (2/425).GERD患者齿状线上移＜3 cm和≥3 cm者中,慢性食管炎、肠上皮化生、不典型增生及肿瘤的发生率分别为85.3％ (267/313)、1.3％ (4/313)、0.9％ (3/313)、0和66.0％(74/112)、23.2％(26/112)、5.4％ (6/112)、2.7％ (3/112).GERD发病与年龄、性别、BMI、吸烟、饮酒、食管裂孔疝及胆汁反流有密切关系.结论中国西北地区内镜中心就诊患者GERD临床检出率较高,年龄大、BMI高、吸烟、饮酒、胆汁反流和食管裂孔疝是其独立危险因素.齿状线上移距离≥3 cm的GERD患者病理改变较严重.
목적 연구중국서북지구내경중심위식관반류병(GERD)환자적림상특정.방법 2008년9월지2009년9월재서안、서저、란주、은천적4소의원내경중심진행문권조사.채용반류진단문권(RDQ)작위진단의거,이증상정도화빈도적분≥12분작위GERD초사표준.종문권학진적GERD환자중수궤추취1/3환자,우치상선하연4개상한각취1괴조직표본송병리조직학검사.자료수입EpiData 3.0수거고,사용SPSS 15.0진행통계학분석.결과 획취합격문권12 454빈,경RDQ공진단GERD환자1246례,총체검출솔위10.0％.425례GERD환자행활조직검사,기중치상선상이거리＜3 cm자점73.6％ (313/425),치상선상이거리≥3 cm자점26.4％ (112/425)；병리결과현시,정상식관점막점9.9％(42/425),만성식관염점80.2％ (341/425),장상피화생점7.1％(30/425),저도불전형증생점1.9％(8/425),고도불전형증생화린상세포암균위0.2％(1/425),식관선암점0.4％ (2/425).GERD환자치상선상이＜3 cm화≥3 cm자중,만성식관염、장상피화생、불전형증생급종류적발생솔분별위85.3％ (267/313)、1.3％ (4/313)、0.9％ (3/313)、0화66.0％(74/112)、23.2％(26/112)、5.4％ (6/112)、2.7％ (3/112).GERD발병여년령、성별、BMI、흡연、음주、식관렬공산급담즙반류유밀절관계.결론 중국서북지구내경중심취진환자GERD림상검출솔교고,년령대、BMI고、흡연、음주、담즙반류화식관렬공산시기독립위험인소.치상선상이거리≥3 cm적GERD환자병리개변교엄중.
Objective To investigate the clinical characteristics of gastro esophageal reflux disease (GERD) in several endoscopy centers of Northwest China.Methods From September 2008 to September 2009,a questionnaire survey was carried out in the endoscopy centers of four hospitals in Xi'an,Xining,Lanzhou and Yinchuan.Reflux diagnostic questionnaire (RDQ) was used as diagnostic evidence.The score of symptom degree and frequency over 12 was considered as initial screening standard.One third GERD patients diagnosed by questionnaire were randomly selected.From each quadrant below the squamocolumnar junction (SCJ),one specimen was taken for pathologic examination.All the data were input into database with EpiData 3.0 software and analyzed with SPSS 15.0 software.Results A total of 12 454 eligible questionnaires were collected,1246 GERD patients were diagnosed according to RDQ,the total detection rate was 10.0％.A total of 425 cases received biopsy,the percentage of cases with upward shift of the SCJ less than 3 cm was 73.6％ (313/425) and over 3 cm was 26.4 ％ (112/425).The pathologic results indicated the percentage of normal mucosa was 9.9％ (42/425),chronic oesophagitis was 80.2％ (341/425),intestinal metaplasia was 7.1％ (30/425),mild atypical hyperplasia was 1.9％ (8/425),severe atypical hyperplasia and squamous cell carcinoma was 0.2％ (1/425) and adenocarcinoma was 0.4％ (2/425).Among the GERD patients with and upward shift of SCJ less than 3 cm and over 3 cm,the incidence of chronic inflammation,intestinal metaplasia,atypical hyperplasia and neoplasm was 85.3％ (267/313),1.3％ (4/313),0.9％ (3/313),0 and 66.0％ (74/112),23.2％ (26/112),5.4％ (6/112),2.7％ (3/112) respectively.The pathogenesis of GERD was closely related with smoking,age,gender,body mass index (BMI),alcohol intake,esophageal hiatal hernia and bile reflux.Conclusions The detection rate of GERD was high in Northwest China endoscopy centers.Age,BMI,alcohol,smoking,esophageal hiatal hernia and bile reflux were independent risk factors.The pathologic changes were more sever in the GERD patients with an upward shift of SCJ less than 3 cm.