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摘要: 目的 分析广东地区胃镜检出反流性食管炎(reflux esophagitis，RE)的时间分布和合并疾病分布情况。 方法 分析2014年1月1日—2024年1月1日于广州中医药大学第一附属医院行胃镜检查的患者中RE的检出率，对病例资料进行回顾性分析，提取性别、年龄、检查日期和结论，然后对检查结论进行结构化信息提取。 结果 RE检出率为9.87%。RE分级为A级11 595例(73.9%)，B级2 976例(19.0%)，C级860例(5.5%)，D级258例(1.6%)。其中男11 515例(73.4%)，女4 174例(26.6%)，男女比例2.8∶1.0。夏季检出病例数最多，为4 097例(26.1%)，四季间检出率比较差异有统计学意义(P < 0.05)。在检出节气方面，RE的发病节气高峰点为寒露，相对高峰期为惊蛰至立夏。在合并疾病方面，合并最多的是慢性浅表性胃炎伴糜烂，共6 454例(41.14%)，合并消化性溃疡中以十二指肠溃疡2 513例(16.02%)为多，合并十二指肠炎2 349例(14.97%)。 结论 广东地区RE检出以青中年、A级、夏季人数较多，寒露为发病高峰点，相对高峰期为惊蛰至立夏；性别上男性多于女性；合并疾病种类较多，以慢性浅表性胃炎伴糜烂、十二指肠炎、十二指肠溃疡、胃息肉多见。Abstract: Objective To analyze the temporal distribution and comorbidities of reflux esophagitis (RE) detected by gastroscopy in the Guangdong region. Methods We conducted a retrospective analysis of patients who underwent gastroscopy at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between January 2014 and January 2024. We calculated the detection rate of RE and extracted case data, including gender, age, examination date, and diagnostic conclusions. We applied a structured data extraction method to analyze the examination results. Results The overall detection rate of RE was 9.87%. The distribution of RE according to the Los Angeles (LA) classification was as follows: 11 595 cases (73.9%) in A, 2 976 cases (19.0%) in B, 860 cases (5.5%) in C, and 258 cases (1.6%) in D. Of these, 11 515 cases were male (73.4%) and 4 174 were female (26.6%), with a male-to-female ratio of 2.8∶1.0. The highest number of cases occurred during the summer, with 4 097 cases (26.1%), demonstrating statistically significant seasonal variation(P < 0.05). The peak incidence of RE was observed during the Cold Dew solar term, with a relative increase from the Awakening of Insects solar term to the Beginning of Summer solar term. The most common comorbidity was chronic superficial gastritis with erosion, found in 6 454 cases(41.14%). Other common comorbidities included duodenal ulcers(2 513 cases, 16.02%) and duodenitis (2 349 cases, 14.97%). Conclusion In Guangdong, RE is commonly detected in younger and middle-aged individuals, with a higher prevalence of A grade. The peak incidence occurs in the summer and shows a seasonal peak during the Cold Dew solar term, with a relative peak from the Awakening of Insects to the Beginning of Summer. Males are more frequently affected than females. Common comorbidities include chronic superficial gastritis with erosion, duodenitis, and duodenal ulcers.
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Key words:
- reflux esophagitis /
- endoscopy /
- temporal distribution /
- disease distribution
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表 1 RE内镜分级与患者年龄的关系
例(%) 年龄/岁 例数 A、B级 C、D级 < 18 89 89(0.6) 0 18~< 45 6 140 5 775(39.6) 365(32.6) 45~< 60 5 833 5 455(37.4) 378(33.8) ≥60 3 627 3 252(22.3) 375(33.5) 
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表 2 RE患者不同分级在各节气分布情况
例(%) 节气 A级 B级 C级 D级 合计 立春 286(2.5) 83(2.8) 25(2.9) 8(3.1) 402 雨水 373(3.2) 115(3.9) 21(2.4) 11(4.3) 520 惊蛰 513(4.4) 152(5.1) 37(4.3) 5(1.9) 707 春分 528(4.6) 148(5.0) 37(4.3) 7(2.7) 720 清明 410(3.5) 100(3.4) 37(4.3) 8(3.1) 555 谷雨 410(3.5) 92(3.1) 31(3.6) 9(3.5) 542 立夏 492(4.2) 135(4.5) 32(3.7) 7(2.7) 666 小满 544(4.7) 130(4.4) 28(3.3) 8(3.1) 710 芒种 494(4.3) 126(4.2) 37(4.3) 10(3.9) 667 夏至 528(4.6) 138(4.6) 37(4.3) 8(3.1) 711 小暑 549(4.7) 128(4.3) 32(3.7) 16(6.2) 725 大暑 528(4.6) 103(3.5) 34(4.0) 10(3.9) 675 立秋 486(4.2) 131(4.4) 57(6.6) 11(4.3) 685 处暑 504(4.3) 119(4.0) 37(4.3) 24(9.3) 684 白露 503(4.3) 127(4.3) 37(4.3) 15(5.8) 682 秋分 307(2.6) 69(2.3) 21(2.4) 5(1.9) 402 寒露 614(5.3) 139(4.7) 33(3.8) 9(3.5) 795 霜降 552(4.8) 143(4.8) 33(3.8) 11(4.3) 739 立冬 495(4.3) 141(4.7) 33(3.8) 11(4.3) 680 小雪 578(5.0) 172(5.8) 53(6.2) 20(7.8) 823 大雪 538(4.6) 130(4.4) 40(4.7) 12(4.7) 720 冬至 473(4.1) 116(3.9) 44(5.1) 12(4.7) 645 小寒 527(4.5) 124(4.2) 48(5.6) 11(4.3) 710 大寒 363(3.1) 115(3.9) 36(4.2) 10(3.9) 524 合计 11 595 2 976 860 258 15 689
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表 3 RE发病的圆形分布统计表
节气 节气中位数累计角度(αi) sinαi cosαi 频数fi Y X 立春 7.40 0.128 8 0.991 7 402 -0.029 9 -0.013 1 雨水 22.19 0.377 7 0.925 9 520 惊蛰 36.99 0.601 7 0.798 7 707 春分 51.78 0.785 6 0.618 7 720 清明 66.58 0.917 6 0.397 5 555 谷雨 81.86 0.989 9 0.141 6 542 立夏 97.15 0.992 2 -0.124 5 666 γ S 小满 112.44 0.924 3 -0.381 7 710 0.032 6 149.892 2 芒种 128.22 0.785 6 -0.618 7 667 夏至 144.00 0.587 8 -0.809 0 711 小暑 159.29 0.353 6 -0.935 4 725 大暑 174.28 0.099 7 -0.995 0 675 立秋 190.36 -0.179 8 -0.983 7 685 处暑 205.64 -0.432 7 -0.901 5 684 白露 220.44 -0.648 7 -0.761 1 682 秋分 235.73 -0.826 4 -0.563 1 402 寒露 251.01 -0.945 6 -0.325 4 795 霜降 265.81 -0.997 3 -0.073 1 739 立冬 280.60 -0.982 9 0.184 0 680 Z 小雪 295.40 -0.903 3 0.428 9 823 16.721 1 大雪 309.70 -0.769 4 0.638 8 720 sinα cosα 冬至 324.49 -0.580 8 0.814 0 645 -0.916 3 -0.400 5 小寒 339.29 -0.353 6 0.935 4 710 大寒 353.10 -0.120 1 0.992 8 524 合计 15 689
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