非典型症状的反流性食管炎临床特征分析

Analysis of the clinical characteristics in reflux esophagitis patients with atypical symptoms

目的分析非典型症状的RE患者临床特征。方法对2009年7月至2011年9月行胃镜检查确诊的140例RE患者,分为典型症状组和非典型症状组,黄型症状组58例,非典型症状组82例,记录患者一般情况、内镜表现、合并疾病等,并行GerdQ量表及相关症状问卷调查,进行统计比较。结果在140例RE患者中男性多于女性,60岁以上非典型症状发生率明显升高,2组年龄分布差异有统计学意义(P<0.05)。内镜下RE严重程度在2组间差异无统计学意义(P>0.05)。两组合并十二指肠球炎、糜烂性胃炎、食管裂孔疝、胆汁反流性胃炎等疾病差异无统计学意义(P>0.05)。非典型症状患者中以食管相关症状为主的占28.05%,以食管外症状为主的占64.63%,无症状的占7.32%。GerdQ量表评分两组间差异有统计学意义(P<0.01)。结论非典型症状的RE临床常见,单凭症状鉴别困难,应提高对RE非典型症状的认识,重视内镜检查,以提高RE患者的检出率。

Objective To analyze the clinical characteristics of reflux esophagitis （RE） patients with atypical symptoms. Methods 140 RE patients ,diagnosed through endoscopy in this hospital from July 2009 to September 2011, were divided into typical and atypical symptom groups. Data on general conditions, endoscopic findings, clinical manifestation and GerdQ scale were investigated and statistically analyzed. Results Of the 140 RE patients ,82 patients had no typical symptoms . There were more males in both groups and patients older than 60 years had a higher incidence rate of atypical symptom group. There were no statistically significant differences in terms of severity on endoscopic findings and complications such as duodenitis, chronic gastritis , hiatal hernia and bile reflux gastritis between two groups （P 〉 0.05 ）. Among atypical symptom group, subgroup esophageal symptom group accounted for 28.05% , extraesophageal symptoms 64.63% , and asymptomatic group 7.32%. GerdQ scale was much lower in atypical symptom group. Conclusion RE patients with atypical symptom group are common in clinic, and it is difficult to differentiate them with those with other diseases. The understanding of the clinical characteristics of RE patients with atypical symptoms should be improved and more attention should be paid to endoscopic examination in order to im- prove the detecting rate of RE.