胃食管反流病症状、PH、内镜的关系探讨

Relations study about the symptoms, PH, endoscopic feature of gastroesophageal reflux diseases

目的：探讨胃食管反流病症状、PH、内镜三者关系：方法：对133例具有烧心、反酸、反食临床表现的患者分别进行症状评估、24小时PH监测.对其中59例患者进行了内镜评估：结果：症状表现正常和轻度占48.1％，中度占33.8％，重度占18％；PH结果提示正常、轻度比例和重度比例高于中度；59例内镜检查结果，内镜诊断为食管炎占55.9％（33／59），内镜检查阴性占44.1％（26／59），食管炎中PH监测正常占15.1％，内镜检查阴性中PH监测异常占80.8％，症状评分表现为中重度，内镜损害为A、B级占71.4％，C、D级仅占28.6％，两者比较P〈0.01。结论：GERD病症状、PH、内镜不呈正相关.需综合症状、PH、内镜三方面资料，或结合胆汁酸监测，才能作出准确诊断，有效指导临床治疗。

Objective：To study the relations on symptoms, PH, endoscopic feature of gastroesophageal reflux diseases （GERD）. Methods：The study was done in 133 cases suffered heartburn, acid reflux, and regurgitation, the symptoms evaluating, 24h PH monitoring was checked respectively, 59 cases was checked by gastroendoscopy. Results： Symptom scores （Sc） normal and mild, moderate , heave was 48.1% ,33.8% , 18% respectively. PH results indication normal, mild, and heave was higher than that of moderate, erosive reflux esophagitis was diagnosed by gastroendoscopy in 55.9% （33/59） cases, they were not founderd esophagitis by gastroendoscopy in 44.1% （26/59） cases, the PH was normal in 15.1% case among espphagitis and in 80.8% case abnormal a-mong negative endoscopic feature. 71.4% esophagitis was A grade or B grade in moderate and heave symptom scores group, C and D grade esophagitis was only 28.6%, P 〈 0.01. Conclusions： symptom, PH, Gastroendoscopic feature was no positive relations, accurate diagnosis GERD need to combine symptom with PH, endoscopic feature or billitect checking, only thus is treatment more effective.