Ott D J, McManus C M, Ledbetter M S, Chen M Y, Gelfand D W
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.
Am J Gastroenterol. 1997 Oct;92(10):1827-30.
Study relationship of gastroesophageal reflux disease to findings on radiographic examination of the esophagus.
We correlated heartburn (HB) in 360 patients (174 women; 186 men; mean age, 53 yr) to results of pH monitoring (pHM) and radiographic examination of the esophagus. Radiographic findings were categorized as normal (n = 129), hiatal hernia (HH) only (n = 173), reflux esophagitis (n = 50), or peptic stricture (n = 8) (ES; 58). Abnormal pHM was defined as total percentage of esophageal acid exposure time (pH < 4) of 6% or greater.
pHM was abnormal in 41 (31%) of 132 patients with HB versus 54 (24%) of 228 without the symptom (p > 0.05). Radiographic correlation showed abnormal pHM in only 21 (16%) of 129 patients with a normal esophagus, 52 (30%) of 173 with HH, and 22 (38%) of 58 with ES, which was significantly lower for those with a normal esophagus. In 132 patients with HB, those with normal esophagus had lower abnormal pHM (2 of 38; 5%) compared with patients with HH (24 of 64; 38%) or with ES (15 of 30; 50%) (p < 0.05). In the 228 patients without HB, abnormal pHM was found in 19 (21%) of 91 with a normal esophagus, 28 (26%) of 109 with HH, and 7 (25%) of 28 with ES (p > 0.05).
(1) pHM findings did not correlate with presence or absence of HB; (2) pHM is usually normal in patients with normal esophagus on RE; (3) pHM is also usually normal in patients with HB and normal esophagus on RE; and (4) pHM is often normal in patients with radiographic findings of reflux esophagitis or peptic stricture.
研究胃食管反流病与食管影像学检查结果之间的关系。
我们将360例患者（174名女性；186名男性；平均年龄53岁）的烧心症状（HB）与pH监测（pHM）结果及食管影像学检查结果进行了关联分析。影像学检查结果分为正常（n = 129）、仅存在食管裂孔疝（HH，n = 173）、反流性食管炎（n = 50）或消化性狭窄（n = 8）（食管狭窄；58例）。异常pHM定义为食管酸暴露时间（pH < 4）的总百分比≥6%。
132例有烧心症状的患者中，41例（31%）pHM异常，而228例无此症状的患者中，54例（24%）pHM异常（p > 0.05）。影像学关联分析显示，食管正常的129例患者中仅21例（16%）pHM异常，HH患者173例中有52例（30%）pHM异常，食管狭窄患者58例中有22例（38%）pHM异常，食管正常者的异常率显著更低。在132例有烧心症状的患者中，食管正常者的异常pHM比例（38例中的2例；5%）低于HH患者（64例中的24例；38%）或食管狭窄患者（30例中的15例；50%）（p < 0.05）。在228例无烧心症状的患者中，食管正常的91例中有19例（21%）pHM异常，HH患者109例中有28例（26%）pHM异常，食管狭窄患者28例中有７例（25%）pHM异常（p > 0.05）。
（1）pHM结果与烧心症状的有无无关；（2）食管正常的反流性食管炎患者pHM通常正常；（3）有烧心症状且食管正常的反流性食管炎患者pHM通常也正常；（4）有反流性食管炎或消化性狭窄影像学表现的患者pHM常正常。
