Significance of Non-erosive Minimal Esophageal Lesions in Gastro-esophageal Reflux Disorder
Significance of Non-erosive Minimal Esophageal Lesions in Gastro-esophageal Reflux Disorder
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非糜烂性微小食管病变在胃食管反流病中的意义
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发表时间：
2004
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通讯作者：
Jung
中科院分区：
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作者：
S. Hong;P. Park;S. Hwang;K. Ko;S. Kwak;Sehyun Kim;K. Kwon;Y. Shin;J. Ryu;K. Ryu;Sang;Wook;H. Yoo;H. Bae;Min;Yeol;K. Kim;K. Kim;Seon;Jung
非糜烂性反流病占胃食管反流病的60%以上，缺乏客观的诊断参数。本研究的目的是评估食管下段非糜烂性微小病变与胃食管反流病之间的相关性。方法采用症状问卷调查。内镜检查结果按照LA分类分级或记录为非糜烂性微小病变。最小病变的患者用雷贝拉唑或安慰剂治疗，并在第1周和第4周评价反应。结果8个中心共筛查3454例患者。在胃灼热或反酸为最令人烦恼的症状的患者中，23.7%有内镜阴性反流障碍，40.1%显示轻微病变，36.2%有粘膜破裂性食管炎。34%的最小病变患者和39.1%的LA“A级”轻度食管炎患者报告典型的反流症状为主要症状。在轻微病变的患者中，雷贝拉唑在第1周和第4周显著减轻了症状，但安慰剂没有。结论非糜烂性微小食管病变患者的反流症状与轻度糜烂性反流性食管炎患者相似，短期质子泵抑制剂可改善反流症状。因此，非糜烂性食管微小病变构成了胃食管反流病的很大一部分。
Background Non-erosive reflux disorder, which represents more than 60% of gastro-esophageal reflux disorders, lacks objective parameters for diagnosis. The purpose of this study was to evaluate the correlation between non-erosive minimal lesions at the lower esophagus and gastro-esophageal reflux disorder. Methods Patients were asked to answer a symptom questionnaire. The endoscopic findings were either graded by LA classification or recorded as non-erosive minimal lesions. Patients with minimal lesions were treated with rabeprazole or a placebo and responses were evaluated at weeks 1 and 4. Results In 8 centers, 3454 patients were screened. In patients with heartburn or acid regurgitation as the most bothersome symptom, 23.7% had endoscopy negative reflux disorder, 40.1% showed minimal lesions, and 36.2% had mucosal break esophagitis. Thirty-four percent of patients with minimal lesions and 39.1% of patients with LA ‘grade A’ mild esophagitis reported typical reflux symptoms as their main symptom. In patients with minimal lesions, medication with rabeprazole reduced symptoms significantly at weeks 1 and 4, but not with the placebo. Conclusion Patients with non-erosive minimal esophageal lesions had similar reflux symptoms comparable to those with mild erosive reflux esophagitis, and reflux symptoms were improved with a short-term proton pump inhibitor. Thus, non-erosive minimal esophageal lesion constitutes a great part of gastro-esophageal reflux disorder.