Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Dig Dis Sci. 2010 Apr;55(4):967-72. doi: 10.1007/s10620-009-1067-y. Epub 2009 Dec 4.
Patients with gastroesophageal reflux disease (GERD) often complain of dysphagia and are frequently found to have intraepithelial eosinophils on esophageal biopsy.
The aim of this study was to investigate the relationship between dysphagia and the number of intraepithelial eosinophils in patients with GERD.
Review of all patients studied in our esophageal function laboratory from 1999 to 2007 identified 1,533 patients with increased esophageal acid exposure. Patients who complained of dysphagia without mechanical or motor causes were identified and divided into three groups based on whether dysphagia was their primary, secondary or tertiary symptom. A control group consisted of randomly selected GERD patients with no dysphagia. The highest number of intraepithelial eosinophils per high-power field (HPF) in biopsies from the squamocolumnar junction (SCJ) and esophageal body was compared across groups.
There were 71 patients with unexplained dysphagia. Dysphagia was the primary symptom in 13 (18%), secondary symptom in 34 (48%), and tertiary symptom in 24 (34%) patients. The number of eosinophils differed between the four groups, with the highest number in those with dysphagia as the primary symptom (P = 0.0007). This relationship persisted whether biopsies were from the SCJ (P = 0.0057) or esophageal body (P = 0.0096).
An association exists between the number of intraepithelial eosinophils and dysphagia in GERD patients, with the highest number of eosinophils in those with the primary symptom of dysphagia.
胃食管反流病（GERD）患者常主诉吞咽困难，并经常在食管活检中发现上皮内嗜酸性粒细胞。
本研究旨在探讨 GERD 患者吞咽困难与上皮内嗜酸性粒细胞数量的关系。
回顾 1999 年至 2007 年在我们食管功能实验室研究的所有患者，确定了 1533 例食管酸暴露增加的患者。确定了主诉吞咽困难且无机械或运动原因的患者，并根据吞咽困难是主要、次要还是次要症状将其分为三组。对照组由随机选择的无吞咽困难的 GERD 患者组成。比较食管鳞柱状交界处（SCJ）和食管体活检中每高倍视野（HPF）上皮内嗜酸性粒细胞的最高数量。
有 71 例患者出现不明原因的吞咽困难。吞咽困难是 13 例（18%）患者的主要症状，是 34 例（48%）患者的次要症状，是 24 例（34%）患者的第三症状。四组之间嗜酸粒细胞数量存在差异，以吞咽困难为主要症状的患者嗜酸粒细胞数量最高（P=0.0007）。这一关系在 SCJ（P=0.0057）或食管体（P=0.0096）活检中均存在。
在 GERD 患者中，上皮内嗜酸性粒细胞数量与吞咽困难之间存在关联，以吞咽困难为主要症状的患者嗜酸粒细胞数量最高。
