175例不同年龄组反流性食管炎回顾性分析

Retrospective analysis of 175 cases of reflux esophagitis in various age groups

目的分析不同年龄组反流性食管炎（RE）患者临床与内镜的相关情况。方法将2003年2月～2007年9月我院经胃镜检出的175例反流性食管炎病例，按洛杉矶分类进行分级，按年龄段分成3组，分析RE的构成比、分级、症状、H．pylori感染、疗效等方面的差异及关系。结果RE的检出率为2．42％，青年组A级和B级RE分别为52．7％、44．6％，中、老年组C级和D级占87．5％，RE男性患者明显多于女性（87．4％vs12．6％），3组H．pylori感染率无差异（P〉0．05）。青年组、中年组、老年组治疗有效率分别为97．3％、92．8％和93．3％（P〉0．05）。结论不同年龄组RE的构成比男性明显高于女性，老年组患者易患重度RE，症状评分对RE有一定的临床诊断价值，RE的发生及严重程度与H．pylori感染之间无相关性，食管外症状的发生率与年龄无相关性，PPI仍是目前治疗RE的主要有效药物.

Objective To study clinical and endoscopy characteristics of reflux esophagitis（RE） among different age groups. Methods Endosopy was performed in 175 patients with RE. Accoding to Los Angeles classification system, the patients were divided into three groups by age stages. The relationship and difference among proportion, classification, symptom, H. pylori infection, and curative effect were analyzed. Results The detection rate of RE was 2.42%. Almost half of young-aged group were classified as grade A and B （proportion of grade A and B, 52.7% and 44.6% , respectively）. In contrast, the total proportion of grade C and D was 87.5% in the middle-older age group. RE predominantly increased in male patients compared with female patients. There was no difference in H. pylori infection in three groups （ P 〉 0.05 ）. The total curative effects of middle-young age group were 97.3 % and 92.8 % respectively and that of older age group was 93.3% （P 〉 0.05 ）. Conclusion The constituent ratio of RE in male is significantly higher than that in female in all three groups. The patients of old group easily suffer from severe RE（grade C and D）. Symptom scores are valuable in diagnosis RE. H. pylori infection has no relationship with development and severity of RE. The incidence of extraesophageus reflux disorders has nothing to do with age. PPI is an important drug for treatment of RE.