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中华消化病与影像杂志(电子版) ›› 2023, Vol. 13 ›› Issue (02) : 68 -72. doi: 10.3877/cma.j.issn.2095-2015.2023.02.002

论著

胃食管阀瓣分级在伴有食管外症状的反流性食管炎的分布特点及意义
李玮佳1, 李振方2, 李聪3, 张倩4, 赵琦2,()   
  1. 1. 250012 济南,山东大学齐鲁医学院
    2. 250013 山东第一医科大学附属中心医院 济南市中心医院消化内科;252000 山东聊城,聊城市人民医院消化内科
    3. 252004 山东聊城,聊城市东昌府区妇幼保健院
    4. 250013 山东第一医科大学附属中心医院 济南市中心医院消化内科
  • 收稿日期:2022-07-12 出版日期:2023-04-01
  • 通信作者: 赵琦
  • 基金资助:
    济南市卫生健康委科技计划项目(2022-2-20)

Distribution characteristics and significance of gastroesophageal flap valve classification in reflux esophagitis with extraesophageal symptoms

Weijia Li1, Zhenfang Li2, Cong Li3, Qian Zhang4, Qi Zhao2,()   

  1. 1. Cheeloo College of Medicine, Shandong University, Jinan 250012, China
    2. Department of Gastroenterology, Central Hospital Affiliated to Shandong First Medical University, Jinan Central Hospital, Jinan 250013, China; Department of Gastroenterology, Liaocheng People′s Hospital, Liaocheng 252000, China
    3. Liaocheng Dongchangfu Maternal and Child Health Hospital, Liaocheng 252004, China
    4. Department of Gastroenterology, Central Hospital Affiliated to Shandong First Medical University, Jinan Central Hospital, Jinan 250013, China
  • Received:2022-07-12 Published:2023-04-01
  • Corresponding author: Qi Zhao
引用本文:

李玮佳, 李振方, 李聪, 张倩, 赵琦. 胃食管阀瓣分级在伴有食管外症状的反流性食管炎的分布特点及意义[J/OL]. 中华消化病与影像杂志(电子版), 2023, 13(02): 68-72.

Weijia Li, Zhenfang Li, Cong Li, Qian Zhang, Qi Zhao. Distribution characteristics and significance of gastroesophageal flap valve classification in reflux esophagitis with extraesophageal symptoms[J/OL]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(02): 68-72.

目的

探讨胃食管阀瓣(GEFV)分级在伴有食管外症状的反流性食管炎(RE)中的分布特点及临床意义。

方法

选择聊城市人民医院、济南市中心医院消化科、呼吸科及耳鼻喉科门诊和住院,行胃镜检查确诊的554例RE患者,按照是否伴有食管外症状(反流性咽喉炎、反流性咳嗽、反流性哮喘)分为对照组与试验组。分析不同年龄段与GEFV异常检出率的关系、RE伴发食管外症状发生率的关系以及GEFV分级与RE伴发食管外症状发生率的关系。

结果

年龄增长与异常GEFV的发生率、食管外症状的发生率呈正相关(r=0.111,P=0.01;r=0.129,P=0.01)。食管裂孔疝发生率随着GEFV分级增加而增加,异常GEFV中食管外症状发生率高于正常GEFV(42.95%比13.07%);试验组的异常GEFV发生率高于对照组(56.30%比20.46%,P=0.04)。食管外症状发生率随着GEFV分级而增加,与GEFV分级呈正相关(χ2=6.502,P=0.01;r=0.286,P=0.015)。重度RE组伴有食管外症状高于轻度RE组(48.51%比12.86%);食管外症状发生率与RE分级呈正相关(r=0.291,P<0.05)。

结论

GEFV分级可作为预测反流性食管炎伴发食管外症状的风险指标,在临床诊治中有一定的预测价值。

Objective

To explore the distribution characteristics and clinical significance of gastroesophageal flap valve(GEFV)classification in patients with reflux esophagitis(RE)with extraesophageal symptoms.

Methods

A total of 554 patients with RE who were diagnosed by endoscopy in Departments of Gastroenterology, Respiratory and Otolaryngology of Liaocheng People′s Hospital and Jinan Central Hospital were selected.All patients were divided into control group and experimental group according to whether accompanied by extraesophageal symptoms(reflux laryngitis, reflux cough, reflux asthma). The relationships between different age groups and abnormal detection rate of GEFV and the incidence of RE with extraesophageal symptoms, and the relationship between GEFV classification and the incidence of RE with extraesophageal symptoms were analyzed.

Results

The increase of age was positively correlated with the incidences of abnormal GEFV and extraesophageal symptoms(r=0.111, P=0.01; r=0.129, P=0.01). The incidence of hiatal hernia increased with GEFV grade.The incidence of extraesophageal symptoms in abnormal GEFV group was significantly higher than that in normal GEFV group(42.95% vs.13.07%). The incidence of abnormal GEFV in the experimental group was higher than that in the control group(56.30% vs.20.46%, P=0.04). The incidence of extraesophageal symptoms increased with GEFV classification and was positively correlated with GEFV classification(χ2=6.502, P=0.01; r=0.286, P=0.015). Extraesophageal symptoms in severe RE group were higher than those in mild RE group(48.51% vs.12.86%). The incidence of extraesophageal symptoms was positively correlated with RE grade(r=0.291, P<0.05).

Conclusion

GEFV classification can be used as a risk index for predicting extraesophageal symptoms in reflux esophagitis, and has certain predictive value in clinical diagnosis and treatment.

图1 内镜下胃食管阀瓣分级注:1A为Ⅰ级;1B为Ⅱ级;1C为Ⅲ级;1D为Ⅳ级
表1 胃食管阀瓣分级、反流性食管炎Los Angels分级与食管外症状发生率的关系[例(%)]
表2 GEFV异常与HH的关系[例(%)]
表3 年龄与食管外症状发生率、胃食管阀瓣分级的关系[例(%)]
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