Lee Kwang Jae, Kwon Heok Chun, Cheong Jae Yeon, Cho Sung Won
Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
Digestion. 2009;79(3):131-6. doi: 10.1159/000209848. Epub 2009 Mar 23.
BACKGROUND/AIMS: The diagnostic criteria for nonerosive reflux disease (NERD) and functional heartburn (FH) have been changed. We investigated demographic, clinical, and psychological characteristics of the heartburn groups classified using the Rome III criteria and factors associated with the responsiveness to proton pump inhibitors (PPIs) in the gastroesophageal reflux disease (GERD) group.
Ninety-five patients with heartburn underwent endoscopy, 24-hour esophageal pH-metry and then a PPI test. NERD was diagnosed when % time with pH <4 was >4%, a symptom index (SI) >or=50% or a positive PPI test in patients without erosive esophagitis. Patients without such findings were classified as FH.
Thirty-six patients had erosive reflux disease (ERD), 36 had NERD, and 23 had FH. The proportion of males was significantly higher in ERD than in FH. Atypical symptoms and IBS were more prevalent in FH than in ERD. Anxiety was more prevalent in FH than in NERD. The prevalence of pathologic acid reflux, a positive SI and a positive PPI test was similar between ERD and NERD patients. In the ERD and NERD groups, depression was independently associated with nonresponsiveness to PPIs.
FH is a different entity from ERD or NERD, particularly in terms of gender, acid reflux patterns, psychological profiles, and the responsiveness to PPIs.
背景/目的：非糜烂性反流病（NERD）和功能性烧心（FH）的诊断标准已经改变。我们调查了使用罗马Ⅲ标准分类的烧心组的人口统计学、临床和心理特征，以及胃食管反流病（GERD）组中与质子泵抑制剂（PPI）反应性相关的因素。
95例烧心患者接受了内镜检查、24小时食管pH监测，然后进行PPI试验。在无糜烂性食管炎的患者中，当pH<4的时间百分比>4%、症状指数（SI）≥50%或PPI试验阳性时，诊断为NERD。无这些发现的患者被分类为FH。
36例患者患有糜烂性反流病（ERD），36例患有NERD，23例患有FH。ERD组男性比例显著高于FH组。FH组非典型症状和肠易激综合征比ERD组更常见。FH组焦虑症比NERD组更常见。ERD和NERD患者病理性酸反流、SI阳性和PPI试验阳性的患病率相似。在ERD和NERD组中，抑郁与对PPI无反应独立相关。
FH是一种与ERD或NERD不同的疾病，特别是在性别、酸反流模式、心理特征和对PPI的反应性方面。
