Lin Bor-Ru, Wong Jau-Min, Chang Mei-Chi, Liao Chien-Chung, Yang Pei-Ming, Jeng Jiiang-Huei, Liao Wan-Ru, Wang Teh-Hong
Division of Endoscopy, Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
J Gastroenterol Hepatol. 2006 Mar;21(3):556-62. doi: 10.1111/j.1440-1746.2005.04003.x.
Gastroesophageal flap valve (GEFV) grade predicts severe gastroesophageal reflux disease in Caucasians, but its role in other populations is unclear. This study evaluated the significance of endoscopic grading of the GEFV in Taiwanese subjects.
Five hundred and six consecutive patients undergoing routine check-ups at the National Taiwan University Hospital were enrolled. Symptoms of upper gastrointestinal disease and endoscopic severity of esophageal mucosal injury were correlated to GEFV grades according to the Hill classification.
The frequency of abnormal valves (Hill grades III or IV) was 27.3%. Of these, 42.7% had erosive esophagitis (EE). The majority of patients with EE were classified as Los Angeles grades A and B (79.7 and 16.9%, respectively). The prevalence of EE, hiatal hernia and, to a lesser degree, non-erosive reflux disease, increased with altered GEFV. Patients with abnormal valves were younger and more likely to be male, overweight, and to have atypical and extraesophageal symptoms.
Taiwanese patients with abnormal GEFVs share similar characteristics and risk factors with the patients who have EE. Endoscopic grading of the GEFV is highly associated with GERD, and in particular EE, in subjects undergoing routine endoscopy.
胃食管瓣阀（GEFV）分级可预测白种人中的严重胃食管反流病，但它在其他人群中的作用尚不清楚。本研究评估了台湾受试者中GEFV内镜分级的意义。
纳入506例在台湾大学医院接受常规检查的连续患者。根据希尔分类法，将上消化道疾病症状和食管黏膜损伤的内镜严重程度与GEFV分级相关联。
异常瓣膜（希尔分级III或IV级）的发生率为27.3%。其中，42.7%患有糜烂性食管炎（EE）。大多数EE患者被分类为洛杉矶分级A和B（分别为79.7%和16.9%）。随着GEFV改变，EE、食管裂孔疝以及程度较轻的非糜烂性反流病的患病率增加。瓣膜异常的患者更年轻，更可能为男性、超重，并有非典型和食管外症状。
GEFV异常的台湾患者与患有EE的患者具有相似的特征和危险因素。在接受常规内镜检查的受试者中，GEFV的内镜分级与GERD尤其是EE高度相关。
