非糜烂性胃食管反流病与食管胃结合部黏膜病变的相关性研究及其危险因素分析

doi:10.3969/j.issn.1006-6233.2024.02.026

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摘要 目的: 探讨非糜烂性胃食管反流病(NERD)与食管胃结合部黏膜隆起性病变的相关性,为NERD内镜下诊断提供证据;同时分析NERD的危险因素。方法: 前瞻性收入2022年01月至2022年12月在我院行胃镜检查的患者,符合纳入标椎的患者纳入NERD组,同期无症状于我院体检行胃镜检查的患者纳入对照组。对比两组患者的一般人口学因素及内镜下因素,分析NERD与食管胃结合部黏膜隆起性病变的关系。结果: 单因素分析显示,NERD组与对照组的性别、年龄、BMI、饮食习惯、饮酒、服用NSAIDs、胃食管阀瓣分级、食管胃结合部黏膜隆起性病变、胆汁反流及HP感染比较差异有统计学意义(P<0.05);经Logistic回归分析,女性、高BMI、不良饮食习惯、饮酒、服用NSAIDs、胃食管阀瓣松弛(Ⅲ+Ⅳ级)、食管胃结合部黏膜隆起性病变、胆汁反流及HP感染是影响NERD的相关因素;食管胃结合部黏膜隆起性病变对NERD判断的灵敏度为45.83%,特异度为86.27%。结论: 食管胃结合部黏膜隆起性病变与NERD有着明显的关系,可将其作为NERD的一项支持性诊断证据,提高诊断的可靠性。女性、高BMI、饮酒、服用NSAIDs、不良饮食习惯、胃食管阀瓣松弛(Ⅲ+Ⅳ级)、胆汁反流等是影响NERD的独立危险因素;HP感染是NERD的保护因素。

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关键词 ：非糜烂性胃食管反流病, 食管胃结合部, 黏膜隆起性病变, 相关性, 危险因素

Abstract：Objective: To explore the correlation between non-erosive gastroesophageal reflux disease (NERD) and the mucosal bulge lesions of esophagogastric junction, and to provide the basis for the diagnosis of NERD under endoscopy. Risk factors of NERD were also analyzed. Methods: A prospective study was conducted on patients who underwent gastroscopy from January 2022 to December 2022. Patients meeting the inclusion criteria were categorized into the NERD group, while asymptomatic patients who underwent gastroscopy during the same period were included in the control group. General demographic and endoscopic factors were compared between the two groups, and the relationship between NERD and mucosal bulge lesions at the esophagogastric junction was analyzed. Results: Univariate analysis revealed significant differences in gender, age, BMI, dietary habits, drinking, NSAID use, gastroesophageal flap valve classification, mucosal bulge lesions at the esophagogastric junction, bile reflux, and HP infection between the NERD and control groups (P<0.05). Logistic regression analysis identified female gender, high BMI, poor dietary habits, drinking, NSAID use, gastroesophageal flap valve relaxation (III+IV), mucosal bulge lesions at the esophagogastric junction, bile reflux, and HP infection as factors influencing NERD. The sensitivity and specificity of mucosal bulge lesions at the esophagogastric junction for NERD were 45.83% and 86.27%, respectively. Conclusion: Mucosal bulge lesions at the esophagogastric junction are significantly correlated with NERD, serving as supportive diagnostic evidence and enhancing diagnostic reliability. Female gender, high BMI, drinking, NSAID use, poor dietary habits, gastroesophageal flap valve relaxation (Ⅲ+Ⅳ), and bile reflux are independent risk factors for NERD, while HP infection is a protective factor.

Key words： Non-erosive gastroesophageal reflux disease Esophagogastric junction Mucosal bulge lesions Correlation Risk factors

基金资助:2023年承德市科学技术研究与发展计划项目,(编号:202303A017)

通讯作者: 郝欣

引用本文:

龙晓田, 张萌, 花海洋, 李建辉, 郝欣. 非糜烂性胃食管反流病与食管胃结合部黏膜病变的相关性研究及其危险因素分析[J]. 河北医学, 2024, 30(2): 306-312.
LONG Xiaotian, ZHANG Meng, et al. Correlation Study and Risk Factor Analysis of Non-Erosive Gastroesophageal Reflux Disease with Mucosal Bulge Lesions at the Esophagogastric Junction. HeBei Med, 2024, 30(2): 306-312.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.02.026 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I2/306

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