Chocarro Martínez A, Galindo Tobal F, Ruiz-Irastorza G, González López A, Alvarez Navia F, Ochoa Sangrador C, Martín Arribas M I
Department of Internal Medicine, Hospital Virgen de la Concha, Zamora, Spain.
Eur J Clin Microbiol Infect Dis. 2000 Feb;19(2):96-100. doi: 10.1007/s100960050437.
The role of gastric acid inhibitors as predisposing factors for Candida esophagitis is unknown. A retrospective case-control study of esophageal candidiasis was conducted in human immunodeficiency virus (HIV)-negative patients diagnosed from January 1991 to December 1997. The diagnosis of esophageal candidiasis was always made on the basis of endoscopic and histological criteria. Fifty-one patients were diagnosed with esophageal candidiasis, 15 of whom had esophageal complaints and 48 of whom suffered from another previous chronic disease (17 had cancer). In addition, 20 patients had previously been treated with antibiotics, 13 with steroids and 14 with omeprazole. In the multivariate analysis, neoplasm (odds ratio, 5.50; 95% confidence interval, 1.94-15.56) and therapy with antibiotics (odds ratio, 11.97; 95% confidence interval, 3.82-37.45), steroids (odds ratio, 35.52; 95% confidence interval, 3.90-324.01) or omeprazole (odds ratio, 18.23; 95% confidence interval, 4.67-71.03) were all associated with esophageal candidiasis. These data suggest that Candida esophagitis tends to occur in patients with chronic diseases, most of whom have been previously treated with antibiotics, steroids or omeprazole. The findings support the hypothesis that treatment with omeprazole favors the development of esophageal candidiasis.
胃酸抑制剂作为念珠菌性食管炎的诱发因素，其作用尚不清楚。我们对1991年1月至1997年12月诊断的人类免疫缺陷病毒（HIV）阴性患者进行了一项念珠菌性食管炎的回顾性病例对照研究。念珠菌性食管炎的诊断始终基于内镜和组织学标准。51例患者被诊断为念珠菌性食管炎，其中15例有食管症状，48例曾患有另一种慢性疾病（17例患有癌症）。此外，20例患者曾接受过抗生素治疗，13例接受过类固醇治疗，14例接受过奥美拉唑治疗。在多变量分析中，肿瘤（比值比，5.50；95%置信区间，1.94 - 15.56）以及抗生素治疗（比值比，11.97；95%置信区间，3.82 - 37.45）、类固醇治疗（比值比，35.52；95%置信区间，3.90 - 324.01）或奥美拉唑治疗（比值比，18.23；95%置信区间，4.67 - 71.03）均与念珠菌性食管炎相关。这些数据表明，念珠菌性食管炎倾向于发生在患有慢性疾病的患者中，其中大多数患者此前曾接受过抗生素、类固醇或奥美拉唑治疗。这些发现支持了奥美拉唑治疗有利于念珠菌性食管炎发展的假说。
