Oberg S, Ritter M P, Crookes P F, Fein M, Mason R J, Gadensytätter M, Brenner C G, Peters J H, DeMeester T R
Department of Surgery, University of Southern California School of Medicine, Los Angeles, California 90033-4612, USA.
J Gastrointest Surg. 1998 Nov-Dec;2(6):547-53; discussion 553-4. doi: 10.1016/s1091-255x(98)80055-3.
Gastroeosphageal reflux disease has been associated with long segments of Barrett's esophagus </=3 cm), but little is known about its association with shorter segments. The aim of this study was to evaluate anatomic and physiologic alterations of the cardia and esophageal exposure to gastric and duodenal juice in patients with short and long segments of Barrett's esophagus. Furthermore, these patients were compared to each other and to patients with erosive esophagitis and those with no mucosal injury. Two hundred sixty-two consecutive patients with foregut symptoms were divided into the following four groups based on endoscopic and histologic findings: group 1, no mucosal injury; group 2, erosive esophagitis; group 3, short-segment Barrett's esophagus; and group 4, long-segment Barrett's esophagus. Esophageal exposure time to acid and bilirubin, lower esophageal sphincter characteristics, and endoscopic anatomy of the cardia were compared between the groups. Patients with short-segment Barrett's esophagus had elevated esophageal acid and bilirubin exposure, decreased lower esophageal sphincter pressure and length, and a high incidence of hiatal hernia. These abnormalities were similar to those in patients with esophagitis and in general less profound than those found in patients with long-segment Barrett's esophagus. The length of intestinal metaplasia was higher in patients with a defective lower esophageal sphincter. Short-segment Barrett's esophagus is a complication of severe gastroesophageal reflux disease and is associated with the reflux of both gastric and duodenal juice similar to that seen in patients with long-segment Barrett's esophagus.
胃食管反流病与长段（≤3 cm）的巴雷特食管相关，但对于其与较短段巴雷特食管的关联了解甚少。本研究的目的是评估短段和长段巴雷特食管患者贲门的解剖和生理改变以及食管暴露于胃液和十二指肠液的情况。此外，将这些患者相互比较，并与糜烂性食管炎患者和无黏膜损伤患者进行比较。262例连续的有前肠症状的患者根据内镜和组织学检查结果分为以下四组：第1组，无黏膜损伤；第2组，糜烂性食管炎；第3组，短段巴雷特食管；第4组，长段巴雷特食管。比较了各组之间食管暴露于酸和胆红素的时间、食管下括约肌特征以及贲门的内镜解剖结构。短段巴雷特食管患者食管酸和胆红素暴露增加，食管下括约肌压力和长度降低，且食管裂孔疝发生率高。这些异常与食管炎患者相似，总体上不如长段巴雷特食管患者严重。食管下括约肌功能不全的患者肠化生长度更高。短段巴雷特食管是严重胃食管反流病的一种并发症，与长段巴雷特食管患者一样，与胃液和十二指肠液反流有关。
