老年胃食管反流病临床特征的研究

Clinical features of gastroesphageal reflux disease in the elderly

目的分析老年胃食管反流病（GERD）患者的临床症状和治疗反应的特点，为提高老年GERD诊治水平提供依据。方法选取2011年2月22日至2012年9月23日期间在仁济医院门诊确诊并进行药物治疗的老年GERD患者（≥60岁）55例，随机抽取同期诊治的非老年GERD患者（〈55岁）55例作为对照。比较分析2组GERD患者的临床症状、内镜下表现、食管运动、酸反流特征以及药物治疗反应等方面的差异。结果老年组GERD患者烧心症状少于非老年患者（P〈0．001）；老年组食管体部运动缺乏、下食管括约肌压力（LESP）较低，但两组酸反流DeMeester评分相当（P=0．112）。两组质子泵抑制剂（PPI）治疗反应均较好（P=0．85）。但PPI初治疗效不理想的老年GERD对加用莫沙必利有治疗反应的患者少于非老年组。结论老年GERD与非老年GERD存在诸多不同特点，了解这些特点对改善老年GERD治疗效果有益。

Objective To analyze clinical features of gastroesophageal reflux disease （GERD） in the elderly for the improvement of diagnosis and treatement. Methods Fifty five outpatients who met the criteria for GERD and received treatment in our hospital from Feb 2nd, 2011 to Sept 23rd, 2012 were chosen as aged patient group （≥60 years）, the non- aged patient group （〈 55 years, n= 55） were randomly selected as controls. Incidence of each symptom, endoscopic manifestation, esophageal function and clinical effect we.re analyzed and compared between two groups. Results The inci- dence of heartburn was significantly lower in aged group （P 〈 0.001 ）. Also, aged patients showed severe esophageal dys- function and lower LES pressure than non-aged ones. The DeMeester Scores （P=0.112） and effects of PPI （P=0.85） were similar in 2 groups. Mosapride was less effective for aged patients whose early PPI medication were not satisfying. Coudusions Better understanding of clinical features of GERD between aged and non-aged groups can benefit the treatment effect.