Contractor Q Q, Akhtar S S, Contractor T Q
Department of Internal Medicine, King Fahad Specialist Hospital, Gassim, Buraidah, Saudi Arabia.
J Clin Gastroenterol. 1999 Apr;28(3):233-7. doi: 10.1097/00004836-199904000-00009.
The authors studied the relationship of endoscopic esophagitis and gastroesophageal flap valve (GEFV) in patients with symptomatic gastroesophageal reflux (GER). On endoscopy, the GEFV was graded as I to IV in 138 patients with acid regurgitation and heartburn relieved by antacids, and in 54 control subjects without symptoms suggestive of GER. Grade of GEFV was correlated with the grade of esophagitis, response to medical treatment, duration of symptoms, obesity, smoking, sex, and age of the patient. Abnormal GEFV (grades III and IV) was more frequent in patients with symptomatic GER, both with and without esophagitis, compared with control subjects (p = 0.000001. p = 0.03). Abnormal GEFV was significantly more common in patients with GER with esophagitis compared with those without (p < 0.00001). There was no significant difference in the distribution of normal and abnormal GEFV in patients with grade I esophagitis. However, grade 2 and grade 3 esophagitis were associated more commonly with an abnormal GEFV (p < 0.00001, p < 0.02 respectively). Hiatal hernia is always associated with an abnormal GEFV. Abnormal GEFV correlated significantly with age (more frequent when older than 40 years). Sex, duration of symptoms (>3 years), response to medical therapy, smoking, and obesity (body mass index > 30 kg/m2) did not correlate significantly with abnormal GEFV. We conclude that endoscopic esophagitis is usually associated with abnormal GEFV. It is more frequent in grades 2 and 3 but not grade 1 esophagitis. It is also encountered more commonly after the age of 40 years.
作者研究了有症状的胃食管反流（GER）患者内镜下食管炎与胃食管瓣阀（GEFV）之间的关系。在内镜检查中，对138例有反酸和烧心症状且服用抗酸剂后症状缓解的患者以及54例无GER症状提示的对照者的GEFV进行I至IV级分级。GEFV分级与食管炎分级、药物治疗反应、症状持续时间、肥胖、吸烟、性别及患者年龄相关。与对照者相比，有症状的GER患者（无论有无食管炎）中异常GEFV（III级和IV级）更为常见（p = 0.000001，p = 0.03）。与无食管炎的GER患者相比，有食管炎的GER患者中异常GEFV明显更常见（p < 0.00001）。I级食管炎患者中正常和异常GEFV的分布无显著差异。然而，2级和3级食管炎更常与异常GEFV相关（分别为p < 0.00001，p < 0.02）。食管裂孔疝总是与异常GEFV相关。异常GEFV与年龄显著相关（40岁以上更常见）。性别、症状持续时间（>3年）、药物治疗反应、吸烟和肥胖（体重指数>30 kg/m²）与异常GEFV无显著相关性。我们得出结论，内镜下食管炎通常与异常GEFV相关。在2级和3级食管炎中更常见，而在1级食管炎中不常见。40岁以后也更常出现。
