Relationship among symptoms, mucosal injury, and acid exposure in gastroesophageal reflux disease
Relationship among symptoms, mucosal injury, and acid exposure in gastroesophageal reflux disease
复制标题
DOI：
10.3760/cma.j.issn.0366-6999.20130559
复制
发表时间：
2013-12-05
影响因子：
6.1
通讯作者：
Liu Yu-lan
中科院分区：
文献类型：
--
作者：
Xu Ding-ting;Feng Gui-jian;Liu Yu-lan
背景症状、内镜检查和pH监测是胃食管反流病（GERD）诊断的基础。他们的关系对初级保健医生有意义，但仍不清楚。方法选取2007年3月至2010年12月在北京大学人民医院接受反流病问卷调查（RDQ）、内镜检查和食管24 h pH监测的患者300例，进行比较分析。分析不同调查类型的特点及其相互关系。（轻度反流性食管炎（RE）OR =2.433，重度RE=8.386），体重指数（BMI）（轻度RE的OR =1.222，重度RE=1.297）和疝轻度RE OR =6.059，重度RE OR =17.547，年龄OR=1.074。问卷调查、内镜检查和pH监测的一致性较差：RDQ与pH监测（kappa=0.061）和内镜检查（kappa=0.044）不一致; pH监测与内镜检查不一致（kappa=0.316）。然而，RE中粘膜损伤的严重程度与病理性酸暴露（PAE）相关：反流发作>5分钟（P=0.035），pH值升高的时间百分比（P= 0.005），
Background Symptoms, endoscopy, and pH monitoring form the basis of diagnosis of gastroesophageal reflux disease (GERD). Their relationship was meaningful for primary care physicians, but still unclear. Our research aimed to compare questionnaire, endoscopy, and pH monitoring and to analyze their correlations.Methods Three hundred patients who underwent the Reflux Disease Questionnaire (RDQ), endoscopy, and esophageal 24-hour pH monitoring from March 2007 to December 2010 in Peking University People's Hospital were enrolled. We analyzed the characteristics of different investigations and their relationships.Results Male (OR for mild reflux esophagitis (RE)=2.433, severe RE=8.386), body mass index (BMI) (OR for mild RE=1.222, severe RE=1.297), and hernia (OR for mild RE=6.059, severe RE=17.547), were found to be the risk factors for RE; age (OR=1.074) was correlated with severe RE. The consistency of questionnaire, endoscopy, and pH monitoring was poor: RDQ did not agree well with pH monitoring (kappa=0.061), nor with endoscopy (kappa=0.044); pH monitoring did not agree well with endoscopy (kappa=0.316). However, the severity of mucosa injury in RE was associated with pathological acid exposure (PAE): reflux episodes of >5 minutes (P=0.035), the percentage time pH