Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK.
Eur J Gastroenterol Hepatol. 2011 May;23(5):389-95. doi: 10.1097/MEG.0b013e328345d429.
Barrett's oesophagus (BO) and oesophageal adenocarcinoma are more common with increasing age and among men. Symptoms of gastrooesophageal reflux disease are equally common in both sexes and at all ages. We hypothesized that reduced postmenopausal female sex hormone levels may remove protection from acid reflux injury, leading to increased oesophagitis and its complications in older women.
To examine the incidence of gastrooesophageal reflux disease and its complications in men and women in a large endoscopy database.
Anonymized data were extracted from endoscopy databases covering an 11-year period. Patients with an endoscopic diagnosis of reflux oesophagitis (RO), BO, hiatus hernia and benign oesophageal stricture and total number and indications for endoscopies were identified.
Out of 154 406 upper gastrointestinal endoscopies, 24 240 (15.7%) patients had RO {13,148 male, 11,092 female, mean age 59 [standard deviation (SD) 17] years}. The incidence of RO increased with age {odds ratio 1.029 [95% confidence interval (CI) 1.026-1.032], P<0.001} but this increase was more marked in women with increasing age [1.01 (1.01-1.02), P<0.001] compared with men. Increasing age was associated with an increased incidence of benign oesophageal stricture [1.02 (1.017-1.023)] and BO [1.02 (1.019-1.021)]. Although the increase in benign oesophageal stricture was more marked in women [1.024 (1.02-1.028) P<0.001] than in men, this was not the case in BO.
RO and its complications, BO and benign oesophageal stricture increase with age. RO, BO and stricture are more common in absolute and relative terms among younger men than younger women. RO and stricture increase more rapidly in women than men so that the prevalence in elderly patients is similar in both sexes.
巴雷特食管（BO）和食管腺癌随着年龄的增长和男性的增加更为常见。胃食管反流病的症状在两性和各年龄段同样常见。我们假设绝经后女性性激素水平降低可能会使酸反流损伤失去保护作用，导致老年女性的食管炎及其并发症增加。
在大型内镜数据库中检查男女胃食管反流病及其并发症的发生率。
从涵盖 11 年的内镜数据库中提取匿名数据。确定内镜诊断为反流性食管炎（RO）、BO、食管裂孔疝和良性食管狭窄以及内镜检查总数和适应证的患者。
在 154406 例上消化道内镜检查中，24240 例（15.7%）患者患有 RO[13148 例男性，11092 例女性，平均年龄 59[标准差（SD）17]岁]。RO 的发病率随年龄增长而增加{比值比 1.029[95%置信区间（CI）1.026-1.032]，P<0.001}，但女性随年龄增长增加更为明显[1.01（1.01-1.02），P<0.001]。随着年龄的增长，良性食管狭窄的发生率增加[1.02（1.017-1.023）]和 BO[1.02（1.019-1.021）]。尽管良性食管狭窄的增加在女性中更为明显[1.024（1.02-1.028），P<0.001]，但在 BO 中并非如此。
RO 及其并发症、BO 和良性食管狭窄随年龄增长而增加。RO、BO 和狭窄在年轻男性中无论是绝对值还是相对值均比年轻女性更为常见。RO 和狭窄在女性中的增加速度快于男性，因此在老年患者中，两性的患病率相似。
