老年患者反流性食管炎的临床特征分析

Analysis of Clinical Characteristics of Reflux Esophagitis in Elderly Patients

[目的]探讨老年患者反流性食管炎（reflux esophagitis,RE）的临床特点.[方法]收集经胃镜检查确诊为RE的患者106例,分为两组：老年组74例,非老年组32例,按照洛杉矶标准分级,同时填写症状调查表.[结果]老年RE内镜检出率（12.5%）明显高于非老年RE（7%）,且重度RE所占比例也高于非老年组（17.6%和6.3%）,典型症状反酸、烧心的发生率老年RE组明显低于非老年RE组（28.4% vs 46.9%,31.1% vs 53.1%）,而非典型症状上腹不适、咳嗽、支气管炎均高于非老年组（64.9% vs 40.6%,63.5% vs 46.9%,48.6% vs 37.5%）,幽门螺杆菌（Hp）感染率在两组间无明显差别（P〉0.05）.[结论]老年RE具有内镜检出率高,食管炎症程度重,典型症状发生率低,非典型症状发生率高;Hp感染率与RE年龄无关的特点.

[Objective] To explore the clinical characteristics of reflux esophagitis（RE） in senile patients. [Methods]Totally 106 patients diagnosed as RE by endoscopy were collected and allocated to senile group（ n =74） and non-senile group（ n = 32）. All patients were classified by Los Angeles standard and completed symptom questionnaire. [Results]The detection rate of RE in senile group was ohviously higher than that in non senile group（12.5% vs 7% ）. The rate of severe RE in senile group was also obviously higher than that in senile group（17.6 % vs 6.3% ）. The incidence of typical reflux symptoms such as regurgitation and heartburn in senile group were markedly lower than those in non-senile group（28.4% vs 46.9%, 31. 1% vs 53. 1%）. The incidence of atypical symptoms, such as bloating, chronic cough and bronchitis in senile group were higher than those in non-senile group（64.9% vs 40.6%, 63.5% vs 46.9%, 48.6% vs 37.5%）. There was no significant difference in H. pylori（Hp） infection rate between two groups（ P 〉0.05）. [Conclusion]RE in old patients has the characteristics such as high endoscopic detection rate, severe esophageal inflammation, low inci denee of typical symptoms and high incidence of atypical symptoms. The Hp infection rate has no correlation with the age of RE.