念珠菌食管炎：巴基斯坦非艾滋病毒感染人群中的危险因素。
Candida esophagitis: risk factors in non-HIV population in Pakistan.
作者信息
Yakoob Javed, Jafri Wasim, Abid Shahab, Jafri Nadeem, Islam Muhammad, Hamid Saeed, Shah Hasnain A, Hussainy Akbar S
机构信息
Section of Gastroenterology, Department of Medicine, Agha Khan University Hospital, Karachi, Pakistan.
出版信息
World J Gastroenterol. 2003 Oct;9(10):2328-31. doi: 10.3748/wjg.v9.i10.2328.
AIM
Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching hospital.
METHODS
Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications' (ICD-9-CM), with candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were studied.
RESULTS
Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34% of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and diabetes mellitus (OR 4.39, CI 1.34-14.42). The frequent clinical symptoms were retrosternal discomfort, dysphagia and epigastric abdominal pain with endoscopic appearance of scattered mucosal plaques. Another endoscopic lesion was associated with candida esophagitis in 15% patients.
CONCLUSION
Carcinomas, diabetes mellitus, corticosteroid and antibiotic therapy are major risk factors for candida esophagitis in Pakistan. It is an easily managed complication that responds to treatment with nystatin.
目的
念珠菌食管炎是免疫功能低下患者常见的感染。本研究旨在确定在一家教学医院就诊的非人类免疫缺陷病毒（HIV）感染患者中其特征。
方法
研究了5年间所有按照国际疾病分类第九版临床修订本（ICD - 9 - CM）编码，经食管胃十二指肠镜检查（EGD）和组织病理学诊断为念珠菌食管炎的患者的临床记录。
结果
51例患者（27例男性，24例女性，年龄范围21 - 77岁，平均年龄52.9岁）符合标准（占EGD检查的0.34%）。常见的易感因素是癌症（比值比3.87，可信区间1.00 - 14.99）和糖尿病（比值比4.39，可信区间1.34 - 14.42）。常见的临床症状是胸骨后不适、吞咽困难和上腹部疼痛，内镜下表现为散在的黏膜斑块。15%的患者存在与念珠菌食管炎相关的另一种内镜病变。
结论
在巴基斯坦，癌症、糖尿病、皮质类固醇和抗生素治疗是念珠菌食管炎的主要危险因素。这是一种易于处理的并发症，对制霉菌素治疗有反应。
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