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摘要: 目的 分析胃镜检出胆汁反流性胃炎的时间分布和合并疾病分布情况。方法 在广州中医药大学第一附属医院高通医学影像信息管理系统的“检查结论”中以“胆汁”进行检索，再以预定检索策略对记录进行筛选，并提取性别、年龄、检查日期和检查结论，然后对检查结论进行结构化信息提取。以X±S、频数(百分比)对数据进行描述，以t检验、单因素方差分析进行组间差异分析。结果 在2001年1月1日—2023年3月21日的220 997条胃镜检查记录中初步检索到16 166条相关病例，经数据筛选，最终得到13 840例(检出率为6.3%)胆汁反流性胃炎患者的资料，其中单纯胆汁反流性胃炎10 535例(76.1%)，合并糜烂3 305例(23.9%)，其中轻度714例(5.2%)，中度588例(4.2%)，重度85例(0.6%)，余未定程度；在2001-2019年，胆汁反流性胃炎病例检出数呈逐年上升趋势(64~1 491例)，第三季度检出数最多(1 362.58±28.17)例，差异有统计学意义。在检出节气方面，立秋最多，检出数为739例(5.3%)。在合并疾病方面，合并胃食管反流病1 487例(10.7%)，以A级(585例，4.2%)、M级(359例，2.6%)、BE级(290例，2.1%)、B级(195例，1.4%)为多；合并食管炎552例(4.0%)；合并十二指肠球炎1 900例(13.7%)；合并消化性溃疡2 020例(14.6%)，以十二指肠球部溃疡(1 676例，12.1%)、胃溃疡(252例，1.8%)为多。结论 胆汁反流性胃炎检出以青年、第三季度、立秋多见，男女分布接近；合并疾病较多，以胃食管反流病、十二指肠球炎、十二指肠球部溃疡多见。Abstract: Objective To analyze the time distribution and comorbid disease distribution of the bile reflux gastritis(BRG) investigated by gastroscopy.Methods First of all, key word "bile" was retrieved from the "examination findings" in the Medical Imagining Information System of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, which system was provided by Guangzhou Gaotong Video Technology Co., Ltd. Next, after data screening with predetermined retrieval strategies, necessary information was extracted, including gender, age, examination date and examination findings. Then, mean±standard deviation and frequency(percentage) were taken to describe the structured data extracted from the examination findings. Moreover, t-test and one-way ANOVA were employed to investigate the inter-group differences.Results 16 166 relevant cases were initially retrieved from 220 997 gastroscopy records since 2001. With data screening, the findings were as follows. Among 13 840(detection rate: 6.3%) patients suffering from BRG, 10 535(76.1%) were diagnosed as only suffering from BRG, while 3 305(23.9%) were also diagnosed as having erosive gastritis, covering 714 mild cases(5.2%), 588 moderate cases(4.2%), 85 severe cases(0.6%) and some cases in undetermined degree. What's more, the number of BRG cases detected from 2001(64 cases) to 2019(1 491 cases) increased year by year. It's significant to find that most cases were detected in the third quarter(1 362.58±28.17), specifically, the Start of Autumn(739 cases, 5.3%, at the peak). Data of the comorbid diseases were as follows: 1 487 cases were comorbid gastroesophageal reflux disease(GERD)(10.7%), and most of them were grade A(585 cases, 4.2%), grade M(359 cases, 2.6%), grade BE(290 cases, 2.1%) and grade B(195 cases, 1.4%); 552 cases(4.0%) were comorbid esophagitis, and most of them were comorbid chronic esophagitis(417 cases, 3.0%); 1 900 cases(13.7%) were comorbid bulbar duodenitis; 2 020 cases(14.6%) were comorbid peptic ulcer, and most of them were comorbid duodenal bulb ulcer(1 676 cases, 12.1%) and comorbid gastric ulcer(252 cases, 1.8%).Conclusion Most BRG patients were the youth, with similar distribution between genders; most BRG cases were detected in the third quarter, specifically, the Start of Autumn; among the comorbid diseases detected, GRED, bulbar duodenitis, and duodenal bulb ulcer were more than the others.
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表 1 季度、季节、月份、节气与每年检出人数均值差异比较
项目 均值 年均值 t P 95%CI 季度 3 460.00±523.46 601.74±429.22 10.921 0.002 2 025.36~3 691.24 季节 3 460.00±543.71 601.74±429.22 10.514 0.002 1 993.14~3 723.46 月份 1 153.33±191.83 601.74±429.22 9.961 < 0.001 429.75~673.52 节气 576.67±114.14 601.74±429.22 -1.074 0.294 -73.23~23.16 
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