乌鲁木齐市Barrett食管的发病情况和内镜下特点临床意义的研究

The prevalence,clinical and endoscopic characteristics of Barrett Esophagus in Urumqi

目的研究乌鲁木齐市Barrett食管(BE)的发病情况和内镜、临床特点及其与反流性食管炎(RE)的关系。方法根据2011年6月4日在重庆召开的全国第二届Barrett食管专题学术研讨会上制定的BE诊治共识作为诊断标准诊断BE,研究BE患者的内镜检出率、内镜下的表现、分型及病理检查结果,分析研究患者的性别、年龄、体重、身高、症状、幽门螺杆菌(Hp)感染情况及其与BE和RE的关系。结果检出BE患者人数为总胃镜检查人数的7.9%,男女之比为1.98∶1,平均年龄(44.6±13.4)岁。其中仅19.14%患者有典型的反流症状。BE内镜分型中短节段占83.85%,多为舌状、岛状这2种形状。食管活检组织病理诊断为肠化型占BE的25.31%,10.04%伴异型增生,Hp阳性率为40.37%。RE检出率为2.07%。0.66%的BE伴RE。BE和RE合并消化性溃疡发生率差异无统计学意义(P>0.05)。结论乌鲁木齐市地区居民BE的患病率较高,多为短节段舌状或岛状,约1/3为肠化型,以中年男性多见,常无症状,部分伴异型增生。体重超重增加了BE的发病风险。Hp感染可能与BE和RE的关系均不密切。

Objective To investigate the incidence clinical and endoscopic characteristics of Barrett’s esophagus （BE） in population of Urumqi city. The relationship between BE and reflux esophagitis RE was also studied. Methods Patients with BE were diagnosed according to new standard by endoscopy and histology. The prevalence, form in endoscopy, histology of biopsy, sex, age, weight, height, symptom, Helicobacter pylori （Hp） infection and relationship between BE and RE were analyzed. Results BE was found in 7.9% of the total endoscopy number, and male vs. female was 1.98∶1, mean age was （44.6±13.4） years old. Only 19.14%of BE patients had typical reflux symptoms. 83.85%of BE patients were with short segment BE. Intestinal metaplasia was detected in 25.31%of BE and dysplasia 10.04%, 40.37%of BE patients were infected with Hp. The detection rate of RE was 2.07%. Patients BE with RE were 0.66%. The manifestation of reflux esophagus and occurrence of peptic ulcer in cases with BE were in paralled to those with RE （P＆gt;0.05）. Conclusion The incidence of BE in Urumqi of China was high. Most of BE were short segment BE and male and had no typical reflux symptoms. Intestinal metaplasia was found in 1/3 of BE patients. Overweight apparently increased the risk for development of BE. Hp had possible no acolse association between BE and RE.