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日本胃食管反流病的临床特征

Clinical characteristics of gastroesophageal reflux disease in Japan.

作者信息

Yamagishi Hatsushi, Koike Tomoyuki, Ohara Shuichi, Abe Yasuhiko, Iijima Katsunori, Imatani Akira, Kato Katsuaki, Shibuya Daisuke, Aida Shigemitsu, Shimosegawa Tooru

机构信息

Division of Gastroenterology Tohoku University graduate School of Medicine, 1-1 Seiryou- Machi, Aobaku, Sendai 980-8574, Japan.

出版信息

Hepatogastroenterology. 2009 Jul-Aug;56(93):1032-4.

Abstract

BACKGROUND/AIMS: Little is known about the correlation between clinical symptoms in daily life and the endoscopic features of gastroesophageal reflux disease (GERD). The study aim is to evaluate the correlation between clinical symptoms in daily life and endoscopic findings in reflux esophagitis (RE), and endoscopically suspected esophageal metaplasia (ESEM) in a large number of Japanese non-clinical cases.

METHODOLOGY

A total of 6504 subjects who underwent an endoscopy for their annual medical check-up at Miyagi cancer society were enrolled in this study. If esophagitis was present, it was graded according to the Los Angeles classification. ESEM describes endoscopic findings consistent with BE that await histological evaluation. It was also investigated the symptom of heartburn as a "typical symptom" of GERD, and dysphagia as an "atypical symptom" of GERD.

RESULTS

The prevalence of heartburn and dysphagia significantly increased concomitantly with endoscopic the esophagitis grading. The prevalence of heartburn was significantly higher in subjects with long segment ESEM than those without it.

CONCLUSION

The prevalence of heartburn and dysphagia were closely associated with RE grading. Long segment ESEM is strongly associated with the reflux symptom and RE. The more frequent the GERD symptoms, the greater the risk for the development of severe RE, and ESEM.

摘要

背景/目的:关于日常生活中的临床症状与胃食管反流病(GERD)内镜特征之间的相关性,目前所知甚少。本研究旨在评估大量日本非临床病例中日常生活中的临床症状与反流性食管炎(RE)内镜检查结果以及内镜疑似食管化生(ESEM)之间的相关性。

方法

共有6504名在宫城癌症协会进行年度体检并接受内镜检查的受试者纳入本研究。若存在食管炎,则根据洛杉矶分类法进行分级。ESEM描述的是与巴雷特食管(BE)相符且有待组织学评估的内镜检查结果。同时还对GERD的“典型症状”烧心以及GERD的“非典型症状”吞咽困难症状进行了调查。

结果

烧心和吞咽困难的患病率随着内镜下食管炎分级显著增加。长段ESEM受试者的烧心患病率显著高于无长段ESEM的受试者。

结论

烧心和吞咽困难的患病率与RE分级密切相关。长段ESEM与反流症状及RE密切相关。GERD症状越频繁,发生严重RE和ESEM的风险就越大。

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