分析反流性食管炎（RE）合并消化性溃疡（PU）的临床和内镜检查特征。

回顾性分析自2015年3月至2021年2月新疆维吾尔自治区人民医院消化科诊治的3311例RE合并PU患者的性别、年龄，消化性溃疡部位和分期，合并上消化道梗阻、食管裂孔疝及幽门螺杆菌感染状况，按照洛杉矶标准（LA）将患者分为轻度RE（LA-A级和LA-B级）合并PU组2977例和重度RE（LA-C级和LA-D级）合并PU组334例，采用χ²检验比较2组性别、合并上消化道梗阻、合并食管裂孔疝及幽门螺杆菌感染状况的差异，采用t检验比较2组年龄差异。

3311例RE合并PU患者男女比例为3.74∶1（2612例vs 699例），轻度、重度RE合并PU患者比例为8.91∶1（2977例vs 334例）；2组患者男女比例比较（2340/637 vs 272/62），差异无统计学意义（P>0.05）；轻度RE合并PU组患者年龄小于重度RE合并PU组[（50.82±13.27）岁vs （57.76±15.11）岁]，差异具有统计学意义（t=-7.72，P<0.001）。PU的部位中十二指肠球部溃疡2471例，占74.63%；所有3540处溃疡中活动期、愈合期溃疡分别为1424处（40.22%）、1384处（39.10%）。重度RE合并PU组合并上消化道梗阻、食管裂孔疝患者占比高于轻度RE合并PU组[108（32.34%） vs 157（5.27%）；67（20.06%） vs 262（8.80%）]，差异具有统计学差异（χ²=305.881、42.539，P均<0.001）。RE合并PU组幽门螺杆菌感染阳性者2444例（73.81%），重度RE合并PU组HP感染者比例更高[80.54%（269/334） vs 73.06%（2175/2977）]，差异具有统计学意义（χ²=8.690，P=0.003）。

RE合并PU患者男性多于女性，以十二指肠球部溃疡多见，多为活动期和愈合期溃疡，幽门螺杆菌感染率高，重度RE合并PU患者更易出现上消化道梗阻及合并食管裂孔疝。

To analyze the clinical and endoscopic features of patients with reflux esophagitis complicated with peptic ulcer.

The date of 3311 patients’ gender, age, the location and stage of peptic ulcer, combined upper gastrointestinal obstruction, esophageal hiatal hernia and the infection of Helicobacter pylori with reflux esophagitis complicated with peptic ulcer were retrospectively analyzed in the Gastroenterology Department of the People’s Hospital of Xinjiang Uygur Autonomous Region from March 2015 to February 2021. Patients were stratified into a mild RE combined with PU group (2977 cases, LA grades A and B) and a severe RE combined with PU group (334 cases, LA grades C and D) according to the Los Angeles (LA) classification system. The chi-square test was used to compare between-group differences in gender, concomitant upper gastrointestinal obstruction, concurrent hiatal hernia and Helicobacter pylori infection status, while the independent-samples t-test was applied for intergroup comparison of age.

3311 case of reflux esophagitis complicated with peptic ulcer, the male to female ratio was 3.74:1 (2612 vs 699), the mild to severe reflux esophagitis ratio was 8.91:1 (2977 vs 334); There was no statistically significant difference in the male-to-female ratio between the two groups (P>0.05). The difference in age between males and females was statistically significant (50.82±13.27 vs 57.76±15.11; t=-7.72, P<0.001). There were 2471 patients with duodenal bulbar ulcer, accounting for 74.63%; Of the 3540 ulcers, 2808 (79.32%) were in the active or healing stage. 157 and 108 cases were developed upper gastrointestinal obstruction, There was a statistical difference between them (P<0.001). 262 and 67 cases of combined hiatal hernia of the esophagus, which were statistically different from each other (P<0.001), 73.06% and 80.54% were the infection rate of Helicobacter pylori, which were statistically different from each other (χ²=8.690, P=0.003).

In patients with reflux esophagitis complicated by peptic ulcer, males are significantly more affected than females. Duodenal bulb ulcers are the most common type, mostly in the active or healing stage. The infection rate of Helicobacter pylori is high. Severe reflux esophagitis complicated by peptic ulcer is more often associated with upper gastrointestinal obstruction and hiatal hernia.