胃镜下胃食管反流病评估新方法-食管裂孔横径法

表1 胃食管阀瓣Hill分级与食管裂孔横径分级胃镜参数对比

因素		Hill阀瓣分级a(n = 554)	食管裂孔横径分级b(n = 749)	统计量	P值
年龄(岁)
Ⅰ级		54.49±13.03	53.53±12.48	t = 0.386	0.700
Ⅱ级		51.58±12.33	51.56±12.69	t = 0.017	0.987
Ⅲ级		51.54±15.09	51.02±14.34	t = 0.458	0.677
Ⅳ级		57.59±14.23	56.23±14.21	t = 0.335	0.740
性别(n)
Ⅰ级	男	8	11	χ2 = 0.031	0.860
	女	39	49
Ⅱ级	男	67	101	χ2 = 0.772	0.380
	女	127	161
Ⅲ级	男	199	244	χ2 = 0.913	0.339
	女	97	139
Ⅳ级	男	11	31	χ2 = 0.189	0.664
	女	6	13
各级例数(n)				χ2 = 5.764	0.124
Ⅰ级		47	60
Ⅱ级		194	262
Ⅲ级		296	383
Ⅳ级		17	44
食管裂孔横径(cm)
Ⅰ级		1(1-1)	1(1-1)	Z = 0	1
Ⅱ级		1.6(1.4-1.8)	1.6(1.4-1.8)	Z = -0.633	0.526
Ⅲ级		2.1(2-2.9)	2.1(2-2.3)	Z = -1.145	0.252
Ⅳ级		3.2(3-3.5)	3.1(3-3.5)	Z = -1.272	0.203
反流性食管炎(n)				χ2 = 2.734	0.603
Ⅰ级		9	12
Ⅱ级		39	45
Ⅲ级		137	169
Ⅳ级		16	31

a: 胃食管阀瓣分级; b: 食管裂孔横径分级; 年龄: F^a = 1.566,

^aP = 0.197, F^b = 2.304,

^bP = 0.076; 性别: χ^2a = 75.223, ^aP = 0.000, χ^2b = 73.604, ^bP = 0.000; 食管裂孔横径: χ^2a = 113.638, ^aP = 0.000, χ^2b = 342.901, ^bP = 0.000; 反流性食管炎: χ^2a = 65.340, ^aP = 0.000, χ^2b = 81.454, ^bP = 0.000.

表2 胃食管阀瓣Hill分级与食管裂孔横径分级高分辨率测压各参数对比

因素	Hill阀瓣分级a(n = 151)	食管裂孔横径分级b(n = 194)	统计量	P值
食管长度
Ⅰ级	25.08±1.96	25.01±1.87	t = 0.088	0.931
Ⅱ级	24.9±2.56	25.09±2.29	t = -0.407	0.684
Ⅲ级	24.03±2.17	24.09±2.32	t = -0.200	0.842
Ⅳ级	21.97±0.1	22.38±2.62	t = -0.265	0.795
LES长度
Ⅰ级	3.31±0.63	3.24±0.59	t = 0.263	0.795
Ⅱ级	3.17±0.61	3.08±0.67	t = 0.702	0.484
Ⅲ级	2.87±0.64	2.83±0.64	t = 0.284	0.777
Ⅳ级	2.6±0.2	2.79±0.56	t = -0.573	0.576
腹腔LES长度(cm)
Ⅰ级	1.65±0.72	1.67±0.7	t = -0.055	0. 957
Ⅱ级	1.17±0.77	1.14±0.85	t = 0.164	0.870
Ⅲ级	0.35(0-1.58)	0.5(0-1.5)	Z = -0.091	0.927
Ⅳ级	0(0-)	0(0-1.9)	Z = -0.354	0.723
LES静息压呼吸最小值(mmHg)
Ⅰ级	13.54±10.47	14.75±9.98	t = -0.277	0. 785
Ⅱ级	11.1±9.82	11.14±10.59	t = -0.015	0. 988
Ⅲ级	6.25(2.03-12.5)	7.59±7.57	Z = -0.544	0.587
Ⅳ级	5.8±5.51	3.7(0.35-12.35)	Z = -0.068	0.946
LES静息压呼吸平均值(mmHg)
Ⅰ级	21.29±11.91	23.22±11.72	t = -0.381	0. 707
Ⅱ级	18.12±10.72	17.55±11.67	t = 0.261	0. 795
Ⅲ级	11.82±7.92	11.94±7.86	t = -0.105	0.916
Ⅳ级	6.27±1.19	6.69±5.52	t = -0.129	0.899

LES: 下食管括约肌. a: 胃食管阀瓣分级; b: 食管裂孔横径分级; 食管长度: F^a = 2.938,

^aP = 0.035, F^b = 6.072,

^bP = 0.001; LES长度: F^a = 3.824, ^aP = 0.011, F^b = 3.124, ^bP = 0.027; 腹腔LES长度: χ^2a = 12.563, ^aP = 0.006, χ^2b = 17.742, ^bP = 0.000; LES静息压呼吸最小值(mmHg): χ^2a = 8.643, ^aP = 0.034, χ^2b = 10.675, ^bP = 0.014; LES静息压呼吸平均值: F^a = 7.731, ^aP = 0.000, F^b = 11.117, ^bP = 0.000.

表3 胃食管阀瓣Hill分级与食管裂孔横径分级24 h动态pH阻抗参数对比

因素	Hill阀瓣分级a(n = 46)	食管裂孔横径分级b(n = 59)	统计量	P值
DeMeester评分
Ⅰ级	2.13±1.20	2.13±1.20	t = 0	1
Ⅱ级	1(0.8-2.7)	1.2(0.8-3.6)	Z = -0.559	0.576
Ⅲ级	6.9(0.95-21.25)	5.75(1-21.05)	Z = -0.098	0.922
反流次数
Ⅰ级	45±17.45	45±17.45	t = 0	1
Ⅱ级	46.29±26.69	50.44±30.01	t = -0.466	0.644
Ⅲ级	76.25±38.71	77.75±42.79	t = -0.138	0.891

a: 胃食管阀瓣分级; b: 食管裂孔横径分级; DeMeester评分: χ^2a = 8.174,

^aP = 0.017, χ^2b = 8.127,

^bP = 0.017; 反流次数: F^a = 4.623, ^aP = 0.015, F^b = 4.419, ^bP = 0.017.