Abstract
Objective To investigate the clinical characteristics of gastro esophageal reflux disease (GERD) in several endoscopy centers of Northwest China.Methods From September 2008 to September 2009,a questionnaire survey was carried out in the endoscopy centers of four hospitals in Xi'an,Xining,Lanzhou and Yinchuan.Reflux diagnostic questionnaire (RDQ) was used as diagnostic evidence.The score of symptom degree and frequency over 12 was considered as initial screening standard.One third GERD patients diagnosed by questionnaire were randomly selected.From each quadrant below the squamocolumnar junction (SCJ),one specimen was taken for pathologic examination.All the data were input into database with EpiData 3.0 software and analyzed with SPSS 15.0 software.Results A total of 12 454 eligible questionnaires were collected,1246 GERD patients were diagnosed according to RDQ,the total detection rate was 10.0％.A total of 425 cases received biopsy,the percentage of cases with upward shift of the SCJ less than 3 cm was 73.6％ (313/425) and over 3 cm was 26.4 ％ (112/425).The pathologic results indicated the percentage of normal mucosa was 9.9％ (42/425),chronic oesophagitis was 80.2％ (341/425),intestinal metaplasia was 7.1％ (30/425),mild atypical hyperplasia was 1.9％ (8/425),severe atypical hyperplasia and squamous cell carcinoma was 0.2％ (1/425) and adenocarcinoma was 0.4％ (2/425).Among the GERD patients with and upward shift of SCJ less than 3 cm and over 3 cm,the incidence of chronic inflammation,intestinal metaplasia,atypical hyperplasia and neoplasm was 85.3％ (267/313),1.3％ (4/313),0.9％ (3/313),0 and 66.0％ (74/112),23.2％ (26/112),5.4％ (6/112),2.7％ (3/112) respectively.The pathogenesis of GERD was closely related with smoking,age,gender,body mass index (BMI),alcohol intake,esophageal hiatal hernia and bile reflux.Conclusions The detection rate of GERD was high in Northwest China endoscopy centers.Age,BMI,alcohol,smoking,esophageal hiatal hernia and bile reflux were independent risk factors.The pathologic changes were more sever in the GERD patients with an upward shift of SCJ less than 3 cm. Key words: Northwest China; Gastroscopy; Gastroesophageal reflux; Epidemiologic studies
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