Shimazu Takenori, Matsui Toshiyuki, Furukawa Keiichi, Oshige Kaname, Mitsuyasu Tomoko, Kiyomizu Akihiko, Ueki Toshiharu, Yao Tsuneyoshi
Department of Gastroenterology, Fukuoka University, Chikushi Hospital, 377-1 Zokumyouin, Chikushino 818-8502, Japan.
J Gastroenterol. 2005 Sep;40(9):866-72. doi: 10.1007/s00535-005-1670-4.
The prevalence of gastroesophageal reflux disease (GERD) has reportedly risen in recent years. Difficulties associated with endoscopic diagnosis mean it is not easy to determine its precise prevalence. A prospective study of the prevalence of endoscopy-positive GERD (EP-GERD) was conducted at Higuchi Hospital, a general hospital in Northwestern Kyushu, Japan. The study also correlated factors that might affect prevalence (age, sex, and functions of the gastroesophageal junction).
From consecutive patients undergoing endoscopic examination at Higuchi Hospital between January 2000 and April 2003, 1234 patients without severe complications were examined for the possible presence of GERD. Patients were stratified by age and sex, and the prevalence in each group ascertained. EP-GERD was defined on the four-level scale of the Los Angeles classification. Endoscopic classification of gastroesophageal flap valve ([GEFV] functional anomalie; using a four-level scale), was done as proposed by Hill et al. in 1996, to assess flap-valve morphology. Six items were evaluated: (1) symptoms and primary diseases; (2) prevalence of development of EP-GERD classified by age and sex; (3) endoscopic morphology of the GEFV as an expression of the functions of the gastroesophageal junction, and its prevalence by age and sex; (4) regression analysis and Spearman's rank correlation of GEFV and EP-GERD grades; (5) prevalence of EP-GERD and GEFV stratified by age and analyzed; and (6) multiple regression analysis of EP-GERD and explanatory variables (age, sex, and GEFV).
The overall prevalence of EP-GERD was 5.8% (72/1234) and this patient group was dominated by men. Aging had minimal effect on prevalence in men, but the prevalence rose among women as they aged. The age-stratified prevalence of GEFV functional anomalies was similar to the age-stratified prevalence of EP-GERD in both sexes. The correlation between EP-GERD and GEFV functional anomalies was high regardless of sex.
We postulate that the mechanisms leading to the development of GEFV functional anomalies in men are different from those in women. Future evaluations of EP-GERD should also observe GEFV function.
据报道，近年来胃食管反流病（GERD）的患病率有所上升。内镜诊断存在困难，这意味着确定其确切患病率并非易事。在日本九州西北部的一家综合医院——樋口医院，对内镜检查阳性的GERD（EP-GERD）患病率进行了一项前瞻性研究。该研究还关联了可能影响患病率的因素（年龄、性别以及胃食管交界处的功能）。
从2000年1月至2003年4月在樋口医院接受内镜检查的连续患者中，选取1234例无严重并发症的患者，检查是否存在GERD。患者按年龄和性别分层，并确定每组的患病率。EP-GERD根据洛杉矶分类的四级量表进行定义。按照Hill等人在1996年提出的方法，对胃食管瓣（[GEFV]功能异常；采用四级量表）进行内镜分类，以评估瓣的形态。评估了六个项目：（1）症状和原发性疾病；（2）按年龄和性别分类的EP-GERD发生患病率；（3）作为胃食管交界处功能表现的GEFV内镜形态及其按年龄和性别的患病率；（4）GEFV与EP-GERD分级的回归分析和Spearman等级相关性；（5）按年龄分层并分析的EP-GERD和GEFV患病率；以及（6）EP-GERD与解释变量（年龄、性别和GEFV）的多元回归分析。
EP-GERD的总体患病率为5.8%（72/1234），该患者群体以男性为主。衰老对男性患病率的影响最小，但女性患病率随年龄增长而上升。GEFV功能异常的年龄分层患病率在男女两性中与EP-GERD的年龄分层患病率相似。无论性别如何，EP-GERD与GEFV功能异常之间的相关性都很高。
我们推测导致男性GEFV功能异常发生的机制与女性不同。未来对EP-GERD的评估也应观察GEFV功能。
