McNamara D, Buckley M, Crotty P, Hall W, O'Sullivan M, O'Morain C
Adelaide and Meath Hospital, Trinity College, Dublin, Ireland.
Scand J Gastroenterol. 2002 Jul;37(7):772-7.
Recent epidemiological studies have reported a threefold increase in the incidence of adenocarcinoma of the lower oesophagus and gastro-oesophageal junction (cardia). There are conflicting reports available implicating both gastro-oesophageal reflux disease and Helicobacter pylori infection in the aetiology of carditis and cardia intestinal metaplasia, despite strong evidence to show that these two conditions are, if anything, inversely related. We aimed to determine the prevalence of carditis and cardia intestinal metaplasia in dyspeptic subjects and also their association with H. pylori infection and gastro-oesophageal reflux disease.
Histological samples from the gastric cardia were obtained from dyspeptic subjects. H. pylori status was assessed based on histological, microbiological and rapid urease testing. Gastro-oesophageal disease was diagnosed on the basis of histological evidence and/or erosive oesophagitis. Patient demographics were recorded. Cardia intestinal metaplasia (CIM), when present, was subgrouped as complete or incomplete.
Overall, 276 subjects were enrolled; 163 (59%) had carditis and 36 (13%) CIM. H. pylori infection and gastro-oesophageal reflux disease occurred in 64 (23%) and 150 (54%), respectively. H. pylori infection was strongly associated with carditis and CIM (P<0.001 and P<0.01). Older age and male gender were also associated with inflammation and intestinal metaplasia of the cardia. Gastro-oesophageal reflux was not associated with either entity.
Carditis and CIM occur frequently. Both conditions are strongly associated with H. pylori infection, older age and male gender. There was no association with gastro-oesophageal reflux disease.
近期的流行病学研究报告称，下食管腺癌和胃食管交界（贲门）癌的发病率增加了两倍。关于胃食管反流病和幽门螺杆菌感染与贲门炎和贲门肠化生病因的关系，现有相互矛盾的报道，尽管有强有力的证据表明这两种情况即便有关联，也是呈负相关。我们旨在确定消化不良患者中贲门炎和贲门肠化生的患病率，以及它们与幽门螺杆菌感染和胃食管反流病的关联。
从消化不良患者获取贲门部的组织学样本。基于组织学、微生物学和快速尿素酶检测评估幽门螺杆菌感染状况。根据组织学证据和/或糜烂性食管炎诊断胃食管疾病。记录患者的人口统计学数据。存在贲门肠化生（CIM）时，将其分为完全型或不完全型。
总体而言，共纳入276名受试者；163名（59%）有贲门炎，36名（13%）有CIM。幽门螺杆菌感染和胃食管反流病分别发生于64名（23%）和150名（54%）受试者。幽门螺杆菌感染与贲门炎和CIM密切相关（P<0.001和P<0.01）。年龄较大和男性也与贲门部炎症和肠化生有关。胃食管反流与这两种情况均无关联。
贲门炎和CIM常见。这两种情况均与幽门螺杆菌感染、年龄较大和男性密切相关。与胃食管反流病无关。
