Department of Internal Medicine, National Cheng Kung University Medical Center, 138 Sheng Li Road, Tainan, 70428, Taiwan, ROC.
Surg Endosc. 2011 Aug;25(8):2478-86. doi: 10.1007/s00464-010-1569-x. Epub 2011 Feb 7.
We assessed whether the esophageal mucosa index of hemoglobin (IHb) could assist the Los Angeles (LA) classification in defining the severity of erosive reflux esophagitis (RE) and predicting the treatment response by esomeprazole.
Five hundred twenty-four subjects (424 RE and 100 controls) with normal body mass index and hemoglobin had undergone endoscopy to confirm the RE grade by LA classification and to check the series of IHb values at every centimeter of the esophageal mucosa while withdrawing the endoscope to above the esophageal-gastric junction (EGJ). The RE cases had received esomeprazole for 8 weeks (40 mg/day) to assess the cumulative proportions of sustained symptomatic response (SSR).
The IHb value at the EGJ was higher in RE patients than in controls (P < 0.001). Selecting 70 as the cutoff IHb value at the EGJ, the efficacy to define RE achieved 95.8% (406/424) sensitivity and 94% (94/100) specificity. For the patients with same the LA grade, the length of IHb value >70 above the EGJ (L-IHb70) that is greater than 4 cm correlated with a poor cumulative rate of SSR (P < 0.01).
The IHb value >70 at the EGJ is a reliable indicator of RE. The L-IHb70 can serve as a supplementary indicator to predict the response to esomeprazole index within the same LA grade.
我们评估了血红蛋白食管黏膜指数（IHb）是否可以帮助洛杉矶（LA）分类定义侵蚀性反流性食管炎（RE）的严重程度，并通过埃索美拉唑预测治疗反应。
524 名（424 名 RE 和 100 名对照）具有正常体重指数和血红蛋白的受试者接受内镜检查，通过 LA 分类确认 RE 等级，并在退出内镜至食管胃交界处（EGJ）上方时检查食管黏膜每厘米的一系列 IHb 值。RE 病例接受埃索美拉唑治疗 8 周（40mg/天），以评估持续症状缓解（SSR）的累积比例。
RE 患者的 EGJ 处的 IHb 值高于对照组（P <0.001）。选择 70 作为 EGJ 处的 IHb 截断值，对 RE 的定义效果达到 95.8%（406/424）的敏感性和 94%（94/100）的特异性。对于具有相同 LA 等级的患者，EGJ 上方 IH70 长度（L-IHb70）大于 4cm 与 SSR 累积率差相关（P <0.01）。
EGJ 处的 IHb 值>70 是 RE 的可靠指标。L-IHb70 可以作为预测同一 LA 等级内埃索美拉唑指数反应的补充指标。
