Department of Hepatology and Gastroenterology, Beijing You'an Hospital Affiliated with Capital Medical University, Beijing 100069, China.
BMC Gastroenterol. 2010 Jun 4;10:54. doi: 10.1186/1471-230X-10-54.
Reflux esophagitis (RE) is increasing in prevalence in China. There are very few studies on the prevalence and factors related to RE in patients with chronic liver diseases. The aims of this study were to determine the prevalence of RE by endoscopy in patients with chronic liver diseases and the possible related predictors of RE.
A total of 1,280 patients with chronic liver disease and 29 patients with acute hepatitis A or E were prospectively evaluated. There were 879 and 401 patients with liver cirrhosis or chronic hepatitis, respectively. RE was classified by endoscopy according to the Los Angeles classification scheme.
RE was diagnosed in 36.4% (469/1280) of the chronic liver disease patients, which was significantly higher than in the acute hepatitis patients (10.3% [3/29], P < 0.001). RE accounted for 43.0%, 9.7%, and 60.2% of patients with liver cirrhosis, chronic hepatitis(mild and medium), and liver failure, respectively. A high prevalence of RE existed in patients with liver failure and/or Child B and C liver cirrhosis, with typical symptoms of RE in 21.3% of the patients (100/469). There was a significant relationship between gender, age, ascites, and RE.
The high prevalence of RE among upper endoscopies of patients with severe chronic liver disease was demonstrated. Asymptomatic RE was more common in cirrhotic and liver failure patients. The role of RE in variceal bleeding, however, needs to be demonstrated.
反流性食管炎(RE)在中国的患病率正在上升。关于慢性肝病患者中 RE 的患病率和相关因素的研究很少。本研究旨在通过内镜确定慢性肝病患者中 RE 的患病率以及可能与 RE 相关的预测因素。
共前瞻性评估了 1280 例慢性肝病患者和 29 例急性甲型或戊型肝炎患者。分别有 879 例和 401 例患者患有肝硬化或慢性肝炎。RE 根据洛杉矶分类方案通过内镜进行分类。
在 1280 例慢性肝病患者中诊断出 36.4%(469/1280)的患者患有 RE,明显高于急性肝炎患者(10.3%[3/29],P<0.001)。RE 占肝硬化、慢性肝炎(轻度和中度)和肝功能衰竭患者的 43.0%、9.7%和 60.2%。肝功能衰竭和/或 Child B 和 C 肝硬化患者中存在高 RE 患病率,21.3%(100/469)的患者有典型的 RE 症状。RE 与性别、年龄、腹水有关。
严重慢性肝病患者上消化道内镜检查显示 RE 患病率较高。肝硬化和肝功能衰竭患者更常见无症状性 RE。然而,需要证明 RE 在静脉曲张出血中的作用。