食管黏膜色泽变白与胃食管反流的相关性

Correlation between whitening of esophageal mucosa and gastroesophageal reflux

目的分析食管黏膜色泽变白、鳞状上皮增生与胃食管反流的相关性及其发生的影响因素。方法收集2018年6月至2019年11月在包头医学院第二附属医院消化科内镜中心行内镜检查并符合内镜下食管黏膜色泽变白(A组)、散在鳞状上皮增生(B组)、正常对照(C组)的患者,年龄在18~70岁之间,本院医学伦理委员会批准通过,患者知情且同意,分别选取A组74例,B组26例,C组51例。比较三组的上消化道症状、饮食习惯的差异性。结果A组、B组患者反酸的发生率为25.68%、11.54%,烧心的发生率为12.16%、11.54%,均显著高于C组的0、0;A组患者上腹绞痛的发生率为37.84%,显著高于B组的11.54%;A组、B组患者咽部异物感的发生率为12.16%、11.54%,显著高于C组的0;C组患者吃烫食、进食快的发生率为27.45%、49.02%,显著高于A组的8.11%、17.57%,差异均有统计学意义(P<0.05)。结论食管黏膜色泽变白、散在鳞状上皮增生均与反酸、烧心、咽部异物感等症状显著相关,而与上腹胀、恶心、吞咽困难、咽炎、声音嘶哑、辛辣刺激、吸烟、饮酒等无明确相关性。

Objective To analyze the correlation between the whitening of the esophageal mucosa,squamous epithelial hyperplasia and gastroesophageal reflux and its influencing factors.Methods Patients were collected who were given endoscopy from June 2018 to November 2019 at the Gastroenterology Endoscopy Center,the Second Affiliated Hospital of Baotou Medical College,and were in accordance with the whitening of the esophageal mucosa under endoscopy(group A),scattered squamous epithelial hyperplasia(group B),and normal control(group C).The patients were between 18 and 70 years old.The study was approved by the hospital ethics committee and all patients were well informed and provided their consent.74 people in group A,26 people in group B,51 people in group C were selected respectively.The differences in upper gastrointestinal symptoms and eating habits among the three groups were investigated and compared.Results The incidence rate of acid reflux in group A and group B was 25.68%and 11.54%,and the incidence of heartburn was 12.16%and 11.54%,which were significantly higher than 0 and 0 in group C;the incidence rate of upper abdominal colic in group A was 37.84%,significantly higher than that of 11.54%in group B;the incidence rate of foreign body sensation in the pharynx in group A and group B was 12.16%and 11.54%,significantly higher than that of 0 in group C;the incidence rate of ingesting hot food and fast eating in group C was 27.45%and 49.02%,which were significantly higher than those of 8.11%and 17.57%in group A.The differences in the above results were statistically significant.Conclusion The whitening of the esophageal mucosa and scattered squamous epithelial hyperplasia are significantly related to symptoms such as acid reflux,heartburn,and pharyngeal foreign body sensation.There is no clear correlation with bitter mouth,upper abdominal distension,upper abdominal colic,nausea,dysphagia,pharyngitis,hoarseness,ingesting hot food,fast eating,smoking,and alcohol drinking.