Amano K, Adachi K, Katsube T, Watanabe M, Kinoshita Y
Department of Internal Medicine II, Shimane Medical University, Izumo, Japan.
J Gastroenterol Hepatol. 2001 Feb;16(2):132-6. doi: 10.1046/j.1440-1746.2001.02408.x.
The pathogenetic mechanism responsible for the increased prevalence of reflux esophagitis in the elderly remains controversial. The aim of this study was to determine if an increased occurrence of hiatus hernia (HH) and/or a lower rate of gastric mucosal atrophy (GMA) are the main causes of the increased prevalence of reflux esophagitis in elderly patients.
The prevalence of HH, GMA, and reflux esophagitis was investigated by reviewing the endoscopic films of 2788 consecutive patients examined during a 3-year period.
The prevalence of esophagitis in males was higher than in females (11.6% vs 7.6%, P< 0.0005). The prevalence of reflux esophagitis and HH was found to increase with age in females, but not in male patients. The prevalence of reflux esophagitis in hernia-positive patients also increased with age in women, but not in men. Age, male gender, presence of HH, and closed-type of GMA were significant risk factors for the prevalence of esophagitis (P=0.0001, 0.0229, <0.0001, <0.0001, respectively). In addition, the risk ratios of HH and low-grade GMA for reflux esophagitis increased with age, and this tendency was higher in female patients than in males.
Aging, male gender, HH and closed-type GMA are most likely the risk factors of endoscopically proven reflux esophagitis in Japanese patients.
老年反流性食管炎患病率增加的发病机制仍存在争议。本研究旨在确定食管裂孔疝（HH）发生率增加和/或胃黏膜萎缩（GMA）发生率降低是否是老年患者反流性食管炎患病率增加的主要原因。
通过回顾连续3年期间接受检查的2788例患者的内镜影像，调查HH、GMA和反流性食管炎的患病率。
男性食管炎患病率高于女性（11.6%对7.6%，P<0.0005）。发现女性反流性食管炎和HH的患病率随年龄增加，而男性患者则不然。疝阳性患者中反流性食管炎的患病率在女性中也随年龄增加，而男性则不然。年龄、男性性别、HH的存在以及闭合型GMA是食管炎患病率的重要危险因素（分别为P=0.0001、0.0229、<0.0001、<0.0001）。此外，HH和低度GMA导致反流性食管炎的风险比随年龄增加，且女性患者的这种趋势高于男性。
衰老、男性性别、HH和闭合型GMA很可能是日本患者内镜证实的反流性食管炎的危险因素。
