Frootan Mojgan, Choobtashani Sahar, Azargashb Eznollah, Amin Pourhoseingholi Mohamad, Hamide Moosapour, Zali Mohamad Reza, Haleh Ashraf
Research Center for Gastroenterology & Liver Disease, Shahid Beheshti University MC, Tehran, Islamic Republic of Iran.
Turk J Gastroenterol. 2011 Oct;22(5):464-71. doi: 10.4318/tjg.2011.0249.
BACKGROUND/AIMS: Non-erosive reflux disease and erosive esophagitis are the most common phenotypic presentations of gastroesophageal reflux disease. Recent reports suggest that patients with non-erosive reflux disease treated with antireflux medications show lower symptom improvement rates than patients with erosive esophagitis treated with the same medications. The aim was to assess the acid reflux and symptom patterns of patients with non-erosive reflux disease in comparison with those with erosive esophagitis and to identify different non-erosive reflux disease subgroups.
One hundred and twenty consecutive patients (67 male, age: 37.6±12.9 years) seen for classic heartburn symptoms were evaluated for the study. The patients underwent upper endoscopy and 24-hour ambulatory pH monitoring.
Erosive esophagitis was identified in 51 patients and nonerosive reflux disease in 69 patients. According to pH metric findings (DeMeester Score >14.72 or Fraction Time >4%), 31.9% of the non-erosive reflux disease group and 47.1% of the erosive gastroesophageal reflux disease group had abnormal acid reflux (p=0.134). Erosive esophagitis patients showed a similar pattern of acid reflux to non-erosive reflux disease patients in the different positions (supine and upright). Non-erosive reflux disease-negative (normal pH test) patients demonstrated a significantly lower degree of esophageal acid exposure when compared with those with erosive esophagitis. About 10.6% of the non-erosive reflux disease-negative patients and 45.5% of the non-erosive reflux disease-positive (abnormal pH test) patients had a positive symptom index (≥50%) during the distal pH metry (p=0.003).
Acid reflux characteristics and symptom patterns suggest that the non-erosive reflux disease group represents a heterogeneous group of patients.
背景/目的：非糜烂性反流病和糜烂性食管炎是胃食管反流病最常见的表型表现。近期报告显示，使用抗反流药物治疗的非糜烂性反流病患者的症状改善率低于使用相同药物治疗的糜烂性食管炎患者。本研究旨在评估非糜烂性反流病患者与糜烂性食管炎患者的胃酸反流及症状模式，并识别不同的非糜烂性反流病亚组。
连续纳入120例因典型烧心症状就诊的患者（男性67例，年龄：37.6±12.9岁）进行研究。所有患者均接受了上消化道内镜检查和24小时动态pH监测。
51例患者被诊断为糜烂性食管炎，69例患者被诊断为非糜烂性反流病。根据pH测量结果（DeMeester评分>14.72或反流时间百分比>4%），非糜烂性反流病组中有31.9%的患者以及糜烂性胃食管反流病组中有47.1%的患者存在异常胃酸反流（p=0.134）。糜烂性食管炎患者在不同体位（仰卧位和直立位）的胃酸反流模式与非糜烂性反流病患者相似。与糜烂性食管炎患者相比，非糜烂性反流病pH检测结果为阴性（pH检测正常）的患者食管酸暴露程度显著更低。在远端pH测量期间，约10.6%的非糜烂性反流病pH检测结果为阴性的患者以及45.5%的非糜烂性反流病pH检测结果为阳性（pH检测异常）的患者症状指数呈阳性（≥50%）（p=0.003）。
胃酸反流特征和症状模式表明，非糜烂性反流病组代表了一组异质性患者。
