非糜烂性反流病的临床研究

A Clinical Study of Non-erosive Reflux Disease

目的探讨非糜烂性反流病(NERD)患者与反流性食管炎(RE)患者的异同点。方法30例胃食管反流病(GERD)患者,内镜检查分为NERD和RE两组,分别进行症状、精神心理、生活质量评分;24h食管pH及胆红素同步监测;胃镜检查并活检组织作病理学研究;对部分患者进行随访,比较质子泵抑制剂(PPI)疗效。结果1NERD女性患者的比例(58.82%)较RE女性患者的比例(15.38%)高(P<0.05)。2两组患者在症状评分、对日常生活影响上无显著性差异(P>0.05)。NERD组患者焦虑评分、抑郁评分均较RE组患者高(P<0.05)。3两组的活检病理阳性率无显著性差异(P>0.05)。4NERD患者较RE患者病理反流发生率明显要低(P<0.05)。5NERD患者对治疗反应较RE患者差(P<0.05)。结论NERD可能为与RE不同的反流病。

Objecitve To investigate the differences and similarities between non-erosive reflux disease(NERD) and reflux disease(RE). Methods This study covered 30 patients who were grouped by endoscopy into the cases of NERD (n=17) or RE (n=13). The two groups' symptom, mentality, and damage to life quality were compared. Biopsy was performed at 3 cm above LES in oesophagus. The patients were placed under ambulatory 24-h oesophageal pH and Bilitec2000 monitoring. And their responses to the same anti-reflux treatment were evaluated. Reults ① The proportion of female(58.82%) in NERD group was much higher than that(15.38%) in RE group (P<0.05). ② There was no remarkable difference in symptom, damage to life quality between the NERD and RE groups (P>0.05). But in respect to mentality, the NERD group had significantly higher anxiety and depression scores than did the RE group (P<0.05). ③No noticeable difference in the pathological results of biopsy was seen between the NERD and RE groups (P>0.05). ④ The NERD group had less abnormal reflux, compared with the RE group (P<0.05). ⑤ The NERD group gave less response to treatment, compared to the RE group(P<0.05). Conclusion NERD may be a kind of reflux disease different from RE.