老年人反流性食管炎及Barrett食管的发病情况和内镜临床特点

Prevalence and Characteristics of Reflux Esophagitis and Barrett Esophagus in the Aged

目的研究老年人反流性食管炎(RE)及Barrett食管(BE)的发病情况、内镜临床特点及相互关系。方法根据中国反流性食管病(炎)试行方案诊断RE,根据BE共识(2005重庆)诊断BE,研究老年人中RE及BE患者的内镜下检出率、内镜表现、分型,分析患者的性别、幽门螺杆菌(Hp)感染情况及RE与BE的关系。结果老年人行胃镜检查的患者中RE检出率为3.18%,BE检出率为9.12%,前者显著较低(P<0.01),男女之比分别为2.72、1.95,有典型反流症状者分别占45.21%、36.12%。RE中90.16%为轻中度(Ⅰ、Ⅱ级),BE中短段者占83.38%,多为舌状、岛状或包含这2种形状的混合型。活检病理检查发现伴不典型增生者RE中为18.52%、BE中为20.80%,多为轻中度。胃窦Hp阳性率RE患者为39.13%,BE患者为37.94%。7.70%的BE伴RE。结论老年人RE及BE患病率均较高,男性均多见,RE多为轻中度,BE多为短节段舌状或岛状,近半数患者无典型反流症状,RE与BE相关性不明显。老年人RE及BE的高检出率值得重视。

Objective To investigate clinical and endoscopic characteristics of reflux esophagitis（RE） and Barrett esophagus（BE） and their relationship in the aged. Methods Old patients with RE and BE were diagnosed by new standard by endoscopy and histology. The prevalence, form in endoscopy, histology of biopsy, sex, symptom, helicobactr pylori （ Hp ） infection were analyzised. Results RE was 3. 18% of the totle endoscopy number in old people. The prevalence of BE（9. 12% ） was significantly less than that of RE. Male vs female was 2. 72 in RE and 1.95 in BE. 45.21% of RE and 36. 12% of BE patients have typical reflux symptoms. 90. 16% of RE were mild to moderate and 83. 38% BE patients with short segment BE（SSBE）. Dysplasia were detected in 18.52% of RE patients and 20. 80% in BE. 39. 13% RE and 37. 94% BE patients infected with Hp 7.70% patients in BE were also with RE. Conclusion The incidences of RE and BE are both high in Chinese old patients. RE and BE are more in male than female. Most of RE are mild to moderate and most of BE are SSBE. Less than half patients have no typical reflux symptoms. There isn＇t a close association between BE and RE in the aged.