Fujiwara Y, Nakagawa K, Kuroki T, Kusunoki T, Utsunomiya J
Second Department of Surgery, Hyogo College of Medicine, Japan.
Am J Gastroenterol. 1993 Aug;88(8):1233-6.
We evaluated the relationship between gastroesophageal scintigraphy, endoscopy, and biopsy in 48 gastrectomy patients (33 with reflux and 15 without reflux symptoms). Endoscopic esophagitis was demonstrated in 78.8% of the patients with reflux symptoms, histological esophagitis was found in 72.2% of them, and scintigraphic reflux was found in 81.8%. Either endoscopic or histological esophagitis was recognized in 93.7% of the patients with reflux symptoms, while either scintigraphic reflux or endoscopic esophagitis was demonstrated in 97.0%. Scintigraphic reflux was significantly more common in patients with histological esophagitis than in those without it (92.9% vs. 40%, p < 0.01). In addition, it was found in 74.2% of patients with and 64.7% of patients without endoscopic esophagitis. The reflux index tended to increase as the grades of esophagitis increased; there was an approximate relationship between the two parameters. Our study suggested that scintigraphy reflects histological esophagitis rather than endoscopic esophagitis, and that there was an approximate relationship between the reflux index and the endoscopic grade of esophagitis. In addition, performance of scintigraphy and endoscopy combined with esophageal biopsy increased the diagnostic yield in gastrectomy patients with reflux symptoms.
我们评估了48例胃切除患者（33例有反流症状，15例无反流症状）的胃食管闪烁显像、内镜检查及活检之间的关系。有反流症状的患者中，78.8%存在内镜下食管炎，72.2%存在组织学食管炎，81.8%存在闪烁显像反流。有反流症状的患者中，93.7%可识别出内镜或组织学食管炎，而97.0%可显示闪烁显像反流或内镜下食管炎。组织学食管炎患者中闪烁显像反流显著多于无组织学食管炎者（92.9%对40%，p<0.01）。此外，在内镜下有食管炎和无食管炎的患者中分别有74.2%和64.7%发现闪烁显像反流。反流指数倾向于随食管炎分级增加而升高；这两个参数之间存在近似关系。我们的研究表明，闪烁显像反映的是组织学食管炎而非内镜下食管炎，且反流指数与内镜下食管炎分级之间存在近似关系。此外，闪烁显像与内镜检查联合食管活检可提高有反流症状胃切除患者的诊断率。
