Abstract：
OBJECTIVE: To investigate the significance of endoscopic grading (Hill\'s classification) of gastroesophageal flap valve (GEFV) in the examination of patients with gastroesophageal reflux disease (GERD).
METHODS: One hundred and sixty-two patients undergoing gastroscopy in the Department of Gastroenterology, Xingyi People\'s Hospital between Apr. 2022 and Sept. 2022 were selected by convenient sampling, and data such as GEFV grade, and findings of esophageal high-resolution manometry (HRM) and esophageal 24-h pH/impedance reflux monitoring, and Los Angeles (LA) classification of reflux esophagitis (RE) were collected and compared.
RESULTS: Statistically significant differences in age (F = 9.711, P < 0.001) and hiatal hernia (χ = 35.729, P < 0.001) were observed in patients with different GEFV grades. The resting LES pressures were 12.12 ± 2.79, 10.73 ± 2.68, 9.70 ± 2.29, and 8.20 ± 2.77 mmHg (F = 4.571, P < 0.001) and LES lengths were 3.30 ± 0.70, 3.16 ± 0.68, 2.35 ± 0.83, and 2.45 ± 0.62 (F = 3.789, P = 0.011), respectively, in patients with GEFV grades I-IV. DeMeester score (Z = 5.452, P < 0.001), AET4 (Z = 5.614, P < 0.001), acid reflux score (upright) (Z = 7.452, P < 0.001), weak acid reflux score (upright) (Z = 3.121, P = 0.038), liquid reflux score (upright) (Z = 3.321, P = 0.031), acid reflux score (supine) (Z = 6.462, P < 0.001), mixed reflux score (supine) (Z = 3.324, P = 0.031), gas reflux score (supine) (Z = 3.521, P = 0.024) were different in patients with different GEFV grades, with statistically significant differences. Pearson correlation analysis revealed a positive correlation between RE grade and LA classification of GERD (r = 0.662, P < 0.001), and the severity of RE increased gradually with the increase of the Hill grades of GEFV.
CONCLUSIONS: The Hill grade of GEFV is related to age, hiatal hernia, LES pressure, and the consequent development and severity of acid reflux and RE. Evaluation of esophageal motility and reflux based on the Hill grade of GEFV is of significance for the diagnosis and treatment of GERD.
METHODS: One hundred and sixty-two patients undergoing gastroscopy in the Department of Gastroenterology, Xingyi People\'s Hospital between Apr. 2022 and Sept. 2022 were selected by convenient sampling, and data such as GEFV grade, and findings of esophageal high-resolution manometry (HRM) and esophageal 24-h pH/impedance reflux monitoring, and Los Angeles (LA) classification of reflux esophagitis (RE) were collected and compared.
RESULTS: Statistically significant differences in age (F = 9.711, P < 0.001) and hiatal hernia (χ = 35.729, P < 0.001) were observed in patients with different GEFV grades. The resting LES pressures were 12.12 ± 2.79, 10.73 ± 2.68, 9.70 ± 2.29, and 8.20 ± 2.77 mmHg (F = 4.571, P < 0.001) and LES lengths were 3.30 ± 0.70, 3.16 ± 0.68, 2.35 ± 0.83, and 2.45 ± 0.62 (F = 3.789, P = 0.011), respectively, in patients with GEFV grades I-IV. DeMeester score (Z = 5.452, P < 0.001), AET4 (Z = 5.614, P < 0.001), acid reflux score (upright) (Z = 7.452, P < 0.001), weak acid reflux score (upright) (Z = 3.121, P = 0.038), liquid reflux score (upright) (Z = 3.321, P = 0.031), acid reflux score (supine) (Z = 6.462, P < 0.001), mixed reflux score (supine) (Z = 3.324, P = 0.031), gas reflux score (supine) (Z = 3.521, P = 0.024) were different in patients with different GEFV grades, with statistically significant differences. Pearson correlation analysis revealed a positive correlation between RE grade and LA classification of GERD (r = 0.662, P < 0.001), and the severity of RE increased gradually with the increase of the Hill grades of GEFV.
CONCLUSIONS: The Hill grade of GEFV is related to age, hiatal hernia, LES pressure, and the consequent development and severity of acid reflux and RE. Evaluation of esophageal motility and reflux based on the Hill grade of GEFV is of significance for the diagnosis and treatment of GERD.
摘要：
目的：探讨胃食管瓣(GEFV)内镜分级(Hill’s分型)在胃食管反流病(GERD)患者检查中的意义。
方法：在消化内科接受胃镜检查的一百六十二例患者，兴义市人民医院4月之间。2022年9月2022年是通过方便的抽样选择的，和GEFV等级等数据，以及食管高分辨率测压（HRM）和食管24小时pH/阻抗反流监测的结果，收集并比较洛杉矶（LA）的反流性食管炎（RE）分类。
结果：不同GEFV分级患者在年龄(F=9.711，P<0.001)和食管裂孔疝(χ=35.729，P<0.001)方面差异有统计学意义。静息LES压力分别为12.12±2.79、10.73±2.68、9.70±2.29和8.20±2.77mmHg（F=4.571，P<0.001），LES长度分别为3.30±0.70、3.16±0.68、2.35±0.83和2.45±0.62（F=3.789，P=0.011），分别,GEFVI-IV级患者。DeMeester评分(Z=5.452,P<0.001),AET4(Z=5.614,P<0.001),酸反流评分（直立）（Z=7.452，P<0.001），弱酸反流评分(直立)(Z=3.121,P=0.038),液体回流评分(直立)(Z=3.321,P=0.031),胃酸反流评分(仰卧位)(Z=6.462,P<0.001),混合反流评分（仰卧）（Z=3.324，P=0.031），气体回流评分(仰卧位)(Z=3.521,P=0.024)在不同GEFV分级患者中,具有统计学上的显著差异。Pearson相关分析显示RE分级与GERDLA分级呈正相关(r=0.662,P<0.001)。RE的严重程度随着GEFVHill等级的增加而逐渐增加。
结论：GEFV的希尔等级与年龄有关，食管裂孔疝,LES压力,以及随之而来的酸反流和RE的发展和严重程度。根据GEFV的Hill分级评估食管运动和反流对GERD的诊断和治疗具有重要意义。
方法：在消化内科接受胃镜检查的一百六十二例患者，兴义市人民医院4月之间。2022年9月2022年是通过方便的抽样选择的，和GEFV等级等数据，以及食管高分辨率测压（HRM）和食管24小时pH/阻抗反流监测的结果，收集并比较洛杉矶（LA）的反流性食管炎（RE）分类。
结果：不同GEFV分级患者在年龄(F=9.711，P<0.001)和食管裂孔疝(χ=35.729，P<0.001)方面差异有统计学意义。静息LES压力分别为12.12±2.79、10.73±2.68、9.70±2.29和8.20±2.77mmHg（F=4.571，P<0.001），LES长度分别为3.30±0.70、3.16±0.68、2.35±0.83和2.45±0.62（F=3.789，P=0.011），分别,GEFVI-IV级患者。DeMeester评分(Z=5.452,P<0.001),AET4(Z=5.614,P<0.001),酸反流评分（直立）（Z=7.452，P<0.001），弱酸反流评分(直立)(Z=3.121,P=0.038),液体回流评分(直立)(Z=3.321,P=0.031),胃酸反流评分(仰卧位)(Z=6.462,P<0.001),混合反流评分（仰卧）（Z=3.324，P=0.031），气体回流评分(仰卧位)(Z=3.521,P=0.024)在不同GEFV分级患者中,具有统计学上的显著差异。Pearson相关分析显示RE分级与GERDLA分级呈正相关(r=0.662,P<0.001)。RE的严重程度随着GEFVHill等级的增加而逐渐增加。
结论：GEFV的希尔等级与年龄有关，食管裂孔疝,LES压力,以及随之而来的酸反流和RE的发展和严重程度。根据GEFV的Hill分级评估食管运动和反流对GERD的诊断和治疗具有重要意义。
