Weerasuriya N, Snape J
The King's Mill Hospital NHS Trust, Mansfield road, Sutton in Ashfield, Nottinghamshire, UK.
Dis Esophagus. 2006;19(3):189-92. doi: 10.1111/j.1442-2050.2006.00563.x.
Candida esophagitis in elderly patients is an entity that has not been investigated. We studied candida esophagitis in a population older than 65 years comparing them with an age and sex matched control sample. Diagnosis was made by histological identification of candida associated with inflammation from biopsy material taken during endoscopy. Fifty-six cases and 56 controls were analysed aiming to identify presentation, upper gastrointestinal pathologies associated with candida esophagitis, risk associations and to see whether it was a marker of poor outcome. Classical features clinically associated with esophageal disease were relatively uncommon: dysphagia 14%, oropharyngeal candidiasis 2%, dyspepsia 2%, while anaemia and loss of weight were the main indications for endoscopy (70%). No gastrointestinal pathologies were significantly associated with candida esophagitis. Malignancy, chronic obstructive pulmonary disease and antibiotic use were significantly associated, while there was no association between candida esophagitis and diabetes mellitus, stroke disease or dementia. Survival was significantly less in those with candida esophagitis with a mortality at 6 months of 47% compared to 5% in controls and a 1 year survival of 38% compared to 93% in the control sample. This was independent of disability measured by the modified Rankin scale and patients' residence.
老年患者的念珠菌性食管炎是一个尚未得到研究的实体。我们对65岁以上人群中的念珠菌性食管炎进行了研究，并将他们与年龄和性别匹配的对照样本进行比较。诊断通过在内镜检查期间取自活检材料中与炎症相关的念珠菌的组织学鉴定来进行。分析了56例病例和56例对照，旨在确定临床表现、与念珠菌性食管炎相关的上消化道病变、风险关联，并观察它是否是不良预后的一个指标。临床上与食管疾病相关的典型特征相对少见：吞咽困难占14%，口咽念珠菌病占2%，消化不良占2%，而贫血和体重减轻是内镜检查的主要指征（70%）。没有胃肠道病变与念珠菌性食管炎显著相关。恶性肿瘤、慢性阻塞性肺疾病和抗生素使用与之显著相关，而念珠菌性食管炎与糖尿病、中风疾病或痴呆之间没有关联。念珠菌性食管炎患者的生存率显著较低，6个月时死亡率为47%，而对照组为5%，1年生存率为38%，而对照样本为93%。这与通过改良Rankin量表测量的残疾情况和患者居住地无关。
