浙东地区体格检查人群中糜烂性食管炎326例的临床特征

Clinical characteristics of 326 cases of erosive esophagitis in healthy population undergoing health checkup in Eastern Zhejiang Province

目的探讨体检人群中无症状糜烂性食管炎(AEE)的发病率和糜烂性食管炎出现症状的临床特征。方法回顾性分析2012年1月至2015年12月在宁波市医疗中心李惠利东部医院常规健康体检时行胃镜检查的人群共3 052例。分析AEE与有症状糜烂性食管炎(SEE)患者的人口学特征、内镜下表现、反流相关特征、代谢综合征和生物化学指标。采用配对t检验或卡方检验进行单因素分析,多因素logistic回归分析比较AEE和SEE患者的差异。结果本研究体检人群中糜烂性食管炎326例,发病率为10.7%(326/3 052),其中AEE的发病率为4.9%(151/3 052),占糜烂性食管炎中的46.3%(151/326),SEE的发病率为5.7%(175/3 052),占糜烂性食管炎中的53.7%(175/326)。98.2%(320/326)的患者诊断为轻度食管炎(A级或B级)。单因素分析结果显示,与AEE组相比,SEE组有更多的吸烟者[31.8%(48/151)比45.7%(80/175)]、饮酒者[27.8%(42/151)比41.7%(73/175)]和更高的BMI[(23.95±2.32) kg/m2比(24.53±2.19) kg/m2],差异均有统计学意义(χ^2=6.592、6.859,t=-2.351;P均<0.05);AEE和SEE的年龄、性别、食管裂孔疝、代谢综合征和生物化学指标等方面比较差异均无统计学意义(P均>0.05)。多因素logistic回归分析显示,吸烟(OR=1.67,95%CI 1.05~2.65,P=0.030)、饮酒(OR=1.69,95%CI 1.05~2.72,P=0.030)和高BMI(OR=1.11,95%CI 1.00~1.23,P=0.044)是糜烂性食管炎患者出现反流症状的独立危险因素。结论 AEE在中国较为常见,体检人群中发病率和SEE近似。吸烟、饮酒和高BMI是糜烂性食管炎出现反流症状的危险因素。

Objective To explore the incidence of asymptomatic erosive esophagitis (AEE) and clinical characteristics of symptoms of erosive esophagitis in healthy population undergoing health check-up. Methods From January 2012 to December 2015, at Ningbo Medical Treatment Center Lihuili Eastern Hospital, a total of 3 052 healthy people receiving routine health checkup and underwent gastroendoscopy were retrospectively analyzed. The demographic characteristics, endoscopic findings, reflux-related symptoms, metabolic syndrome and biochemical parameters were analyzed in AEE and symptomatic erosive esophagitis (SEE) patients. T test and Chi square test were performed for univariate analysis, and multivariate logistic regression analysis was used to compare differences between AEE and SEE patients. Results There were 326 cases of erosive esophagitis, and the incidence rate was 10.7%(326/3 052). Among them, the incidence rate of AEE was 4.9%(151/3 052), which accounted for 46.3%(151/326) of erosive esophagitis;and the incidence rate of SEE was 5.7%(175/3 052), and accounted for 53.7%(175/326) of erosive esophagitis. About 98.2%(320/326) of the patients were diagnosed with mild esophagitis (Los Angeles grade A or B). The results of univariate analysis indicated that, compared with AEE group, there were more smokers (31.8%, 48/151 vs. 45.7%, 80/175) and more drinkers (27.8%, 42/151 vs. 41.7%, 73/175), and higher body mass index (BMI)((23.95±2.32) kg/m2 vs.(24.53±2.19) kg/m2) were in SEE group, and the differences were statistically significant (χ^2=6.592 and 6.859, t=-2.351;all P<0.05). There were no significant differences between SEE group and AEE group in age, gender, esophageal hiatal hernia, metabolic syndrome and biochemical indicators (all P>0.05). The results of multivariate logistic regression analysis indicated that smoking (odds ratio (OR)=1.67, 95% confidence interval (CI) 1.05 to 2.65, P=0.030), alcohol drinking (OR=1.69, 95%CI 1.05 to 2.72, P=0.030) and high BMI (OR=1.11, 95%CI 1.00 to 1.23, P=0.044) were the independent risk factors of gastroesophageal reflux symptoms in patients with erosive esophagitis. Conclusions AEE is common in Chinese population, and the incidence is similar to SEE. Smoking, alcohol drinking and high BMI are the risk factors of reflux symptom in patients with erosive esophagitis.