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中华胃食管反流病电子杂志 ›› 2020, Vol. 07 ›› Issue (03) : 177 -181. doi: 10.3877/cma.j.issn.2095-8765.2020.03.009

所属专题: 文献

论著

肠型巴雷特食管危险因素临床分析
美丽克扎提·安扎尔1, 米热阿依·阿布都哈的尔1, 高峰2,()   
  1. 2. 830001 乌鲁木齐,新疆维吾尔自治区人民医院消化科
  • 收稿日期:2020-02-10 出版日期:2020-08-15
  • 通信作者: 高峰

Investigation of risk factors in the patients with intestinal metaplasia of barrett's esophagus

Meilikezhati·Anzhaer1, Miriayi·Abuduhadeer1, Feng Gao2,()   

  1. 1. Department of Abuduhadeer Gastroenterology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
  • Received:2020-02-10 Published:2020-08-15
  • Corresponding author: Feng Gao
引用本文:

美丽克扎提·安扎尔, 米热阿依·阿布都哈的尔, 高峰. 肠型巴雷特食管危险因素临床分析[J/OL]. 中华胃食管反流病电子杂志, 2020, 07(03): 177-181.

Meilikezhati·Anzhaer, Miriayi·Abuduhadeer, Feng Gao. Investigation of risk factors in the patients with intestinal metaplasia of barrett's esophagus[J/OL]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2020, 07(03): 177-181.

目的

探讨肠型化生巴雷特食管(BE)的相关危险因素。

方法

收集2017年1月至2020年1月在新疆维吾尔自治区人民医院诊治的55例肠型BE和性别、居住情况匹配的110例非肠型BE患者的临床资料,对两组患者基本状况、生活习惯以及临床病理参数进行回顾性分析,对比分析两组患者临床资料差异性,利用Logistic回归分析筛选肠型BE发生、发展相关的危险因素。

结果

本院肠型BE患者检出率为3.7%(55例),其中男性占56.4%(31例),女性占43.6%(24例),平均年龄为57.73±6.54岁。肠型和非肠型BE患者在年龄、体重指数(BMI)、是否伴有胃食管反流病(GERD)症状和食管裂空疝、是否有食管癌家族史、血清幽门螺旋菌(HP)感染状态以及按化生的柱状上皮长度分型差异有统计学意义(P<0.05);在吸烟饮酒、咖啡因摄入、饮茶习惯、结肠腺瘤诊断史及BE和结直肠癌家族史等上均无统计学意义(P>0.05)。年龄≥50岁(P=0.031,OR=3.027,95%CI:1.107-8.278)、BMI>25 kg/m2P=0.029,OR=2.300,95%CI:1.089-4.856)和食管癌家族史(P=0.020,OR=2.420,95%CI:1.152-5.084)是肠型BE的危险因素。

结论

年龄≥50岁、高BMI以及食管癌家族史是BE尤其是肠型BE的危险因素,应加强具有上述危险因素的高危人群的健康宣传和管理,注重消化系统内镜监测,防止其发展为恶性肿瘤。

Objective

To explore the risk factors of intestinal metaplasia Barrett's esophagus (BE).

Methods

The clinical data of 55 patients with intestinal metaplasia type BE and 110 patients with non-intestinal metaplasia type BE who were matched by gender and living conditions and treated in our hospital from January 2017 to January 2020 were collected. The basic condition, lifestyle intervention and clinical pathological parameters of the two groups were analyzed retrospectively, meanwhile the differences of clinical data between the two groups were compared. Logistic regression analysis was used to screen the risk factors related to the occurrence and development of intestinal metaplasia type BE.

Results

The detection rate of intestinal metaplasia type BE in our hospital was 3.7% (55 cases), of which 56.4% (31 cases) were males and 43.6% (24 cases) were females. The average age was 57.73±6.54 years old. There were significant differences in age, body mass index (BMI), gastroesophageal reflux disease (GERD) symptoms, esophageal hiatus hernia, family history of esophageal cancer, serum helicobacter pylori(HP) infection status and metaplastic columnar epithelium length between intestinal metaplasia type and non-intestinal metaplasia type of BE, however, there was no statistical significance in smoking, alcohol consumption, caffeine intake, tea drinking habit, diagnostic history of colonic adenoma, family history of BE and colorectal cancer. Age ≥50 years (P=0.031, OR=3.027, 95% CI: 1.107-8.278), BMI >25 kg/m2 (P=0.029, OR=2.300, 95% CI: 1.089-4.856), and family history of esophageal cancer (P=0.020, OR=2.420, 95% CI: 1.152-5.084) were risk factors for intestinal metaplasia type of BE.

Conclusions

Age ≥50 years old, high BMI and family history of esophageal cancer are the risk factors of BE, especially intestinal BE. We should strengthen the health publicity and management of the high-risk population with the above risk factors, pay attention to endoscopic monitoring of the digestive system, and prevent it from developing into malignant tumor.

表1 不同病理分型BE患者生活方式干预比较
表2 不同病理分型BE患者临床资料对比比
表3 肠型BE危险因素的多因素 Logistic 回归分析
1
GIyer Prasad, Kaul Vivek. Barrett's esophagus[J]. Mayo Clin Proc, 2019, 94(9): 1888-1901
2
Qumseya B,Sultan S,Bain P,et al.ASGE guideline on screening and surveillance of Barrett’s esophagus[J]. Gastrointest Endosc. 2019.90(3): 335-359. e2
3
国家消化系统疾病临床医学研究中心中,华医学会消化内镜学分会,中国医师协会消化医师分会.中国巴雷特食管及其早期腺癌筛查与诊治共识(2017年,万宁)[J].中华消化内镜杂志,2017,34(9):609-620
4
BMBo Allanson, navita J, Mirzai B, et al.Early Barrett esophagus-related neoplasia in segments 1cm or longer is always associated with intestinal metaplasia[J]. Mod Pathol, 2017, 30: 1170-1176
5
Rosztóczy A, Izbéki F, Róka R, et al. The evaluation of oesophageal function in patients with different types of oesophageal metaplasia[J]. Digestion, 2011, 84(4): 273-280
6
刘思齐, 詹俊. Barrett食管的诊疗进展[J].中华临床医师杂志(电子版), 2015, 9(03): 477-482
7
Steele D, Baig KKK, Peter S. Evolving screening and surveillance techniques for Barrett's esophagus[J].World J Gastroenterol, 2019, 25(17): 2045-2057
8
孔凡扬, 李兆申. Barrett食管和食管腺癌[J].国际消化病杂志, 2015,35(6): 375-387
9
Chen YH,Yu HC,Lin KH,et al.Prevalence and risk factors for Barrett’s esophagus in Taiwan[J]. World J Gastroenterol, 2019, 25(25): 3231-3241
10
Lv J, Guo L, Liu JJ, et al.Alteration of the esophageal microbiota in Barrett's esophagus and esophageal adenocarcinoma[J]. World J Gastroenterol, 2019, 25(18): 2149-2161
11
Khieu M, Mukherjee S. Barrett Esophagus[J].StatPearls, 2020 Jan
12
陈霞,朱良如,侯晓华.中国人Barrett食管临床特点分析[J].胃肠病学和肝病学杂志, 2008, 17(2): 102-105.
13
曾荣耀,刘静. Barrett食管的危险因素及治疗进展[J].中华消化外科杂志, 2013, 12(10): 807-810
14
房殿春,黄勤,于成功,等.我国Barrett食管相关性疾病的研究进展[J].胃肠病学, 2012, 17(3): 129-134
15
张玲, 蓓里・加帕尔, 王燕. 维吾尔族和汉族老年男性胃食管反流病分型及危险因素分析[J].中华胃食管反流病电子杂志, 2015, 2(1):30-33
16
孙树申, 杜绍山. 巴雷特食管研究现状[J].吉林医学, 2020, 41(4):953-955
17
贺欢, 孔文洁, 高峰. 内镜下黏膜套扎切除术对肠化生型Barrett食管的疗效[J].中华胃食管反流病电子杂志, 2017, 4(4): 161-164
18
Andrici J1, Tio M, Cox MR, et a1.Hiatal hernia and the risk of Barrett's esophagus[J]. J Gastroenterol Hepatol, 2013, 28(3): 415-31
19
Kambhampati S, Tieu AH, Luber B, et a1. Risk Factors for Progression of Barrett’s Esophagus to High Grade Dysplasia and Esophageal Adenocarcinoma[J]. Sci Rep. 2020, 10(1): 4899
20
杨晓琼, 刘畅, 姜政. 幽门螺杆菌感染和Barrett食管的相关性Meta分析[J].重庆医学, 2015, 44(27): 3798-3802
21
Wong T, Tian, Nagar AB. Barrett′s surveillance identifies patients with early esophageal adenocarcinoma[J]. Am J Med, 2010, 123(5): 462-467
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