Kim Byung Chang, Yoon Young Hoon, Jyung Hyun Soo, Chung Jae Bock, Chon Chae Yun, Lee Sang In, Lee Yong Chan
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University, College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2006 May;47(5):363-9.
BACKGROUND/AIMS: The prevalence of gastroesophageal reflux disease (GERD) in Korea was believed to be low until now. Korea is now believed to be on the evolving stage of GERD in its' prevalence. The aims of this study were to evaluate the epidemiologic and clinicopathologic characteristics among the subgroups of GERD i.e. non-erosive GERD (NERD), erosive GERD (ERD) and Barrett's esophagus (BE), and the role of Helicobacter pylori (H. pylori) infection in the pathogenesis of GERD.
A total of 253 patients with typical symptoms of GERD who underwent EGD were enrolled from October 2002 to January 2004. Patients were grouped as NERD, ERD or BE based on the symptoms and endoscopic findings. BE was histologically confirmed if necessary. Various clinical parameters including the status of H. pylori infection were analyzed.
Among 253 patients, 106 patients were classified as NERD while 116 and 31 patients were classified as ERD and BE group respectively. BE and ERD group showed no gender predilection while NERD showed female preponderance (2.31:1, p < 0.05). NERD group were younger (49.57 y.o.) than BE (57.87 y.o.) and ERD (52.30 y.o.) group. About three quarters of the patients of erosive esophagitis were LA-A (74.2%) grade. This suggests the mild nature of erosive esophagitis in Korea. ERD showed significantly higher BMI (kg/m2) compared to NERD (p < 0.05). Hiatal hernia was frequently associated with BE and ERD (p < 0.05), but less frequently in NERD. Overall H. pylori positivity among GERD was significantly lower than the age and gender matched control group (p < 0.05).
Subgroups of GERD in Korea showed different epidemiologic and clinical characteristics. Lower rate of H. pylori infection among GERD group may reflect the protective role of H. pylori infection regarding GERD prevalence in Korea.
背景/目的：直到现在，人们一直认为韩国胃食管反流病（GERD）的患病率较低。现在人们认为韩国正处于GERD患病率不断变化的阶段。本研究的目的是评估GERD各亚组，即非糜烂性GERD（NERD）、糜烂性GERD（ERD）和巴雷特食管（BE）的流行病学和临床病理特征，以及幽门螺杆菌（H. pylori）感染在GERD发病机制中的作用。
2002年10月至2004年1月，共纳入253例有典型GERD症状并接受了上消化道内镜检查（EGD）的患者。根据症状和内镜检查结果将患者分为NERD、ERD或BE组。必要时对BE进行组织学确诊。分析了包括H. pylori感染状况在内的各种临床参数。
253例患者中，106例被分类为NERD，116例和31例分别被分类为ERD组和BE组。BE组和ERD组无性别倾向，而NERD组女性居多（2.31:1，p<0.05）。NERD组患者（49.57岁）比BE组（57.87岁）和ERD组（52.30岁）年轻。约四分之三的糜烂性食管炎患者为洛杉矶分类法（LA）-A（74.2%）级。这表明韩国糜烂性食管炎的病情较轻。与NERD组相比，ERD组的体重指数（BMI，kg/m²）显著更高（p<0.05）。食管裂孔疝常与BE和ERD相关（p<0.05），但在NERD组中较少见。GERD患者总体的H. pylori阳性率显著低于年龄和性别匹配的对照组（p<0.05）。
韩国GERD的各亚组表现出不同的流行病学和临床特征。GERD组中较低的H. pylori感染率可能反映了H. pylori感染对韩国GERD患病率的保护作用。
