Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch and School of Medicine, Taiwan.
J Gastroenterol Hepatol. 2012 Mar;27(3):586-91. doi: 10.1111/j.1440-1746.2011.06881.x.
Asymptomatic erosive esophagitis (AEE) is an easily forgotten subgroup of gastroesophageal reflux disease due to its lack of warning symptoms, despite having the risk of developing complications, such as bleeding, stricture, or even esophageal adenocarcinoma.
A total of 2843 potentially eligible patients were screened at the health management center of Buddhist Tzu Chi General Hospital. A total of 1001 patients responded to the survey and gave informed consent; 998 patients who completed the reflux disease diagnostic questionnaire were enrolled. Of them, 594 patients who had no reflux symptoms were included for final analysis. The presence and severity of erosive esophagitis was graded according to the Los Angeles classification. Active infection of Helicobacter pylori (H. pylori) was determined by the Campylo-like organism (CLO) test during endoscopies.
A total of 14.5% (86/594) of asymptomatic patients had endoscopic findings of erosive esophagitis. In the univariate analysis, male sex and hiatus hernia were significantly associated with AEE. Positive CLO tests had a trend association. Based on the multivariate analysis, male sex (odds ratio [OR]: 2.32, 95% confidence interval [CI]: 1.35-3.98), hiatus hernia (OR: 4.48, 95% CI: 2.35-89.17), and positive CLO test (OR: 0.57, 95% CI: 0.34-0.95) were associated with AEE, as compared to the healthy controls.
AEE is not a rare condition, and constitutes 14.5% of the asymptomatic population. Male sex, hiatus hernia, and H. pylori infection are factors associated with AEE. These findings are not only helpful in identifying such asymptomatic patients, but also provide information to improve understanding of the relationship between H. pylori infection, reflux symptoms, and erosive esophagitis.
无症状性糜烂性食管炎（AEE）是胃食管反流病（GERD）中一个容易被忽视的亚组，因为其缺乏警示症状，尽管存在发展为并发症的风险，如出血、狭窄，甚至食管腺癌。
在佛教慈济综合医院的健康管理中心共筛选了 2843 名潜在合格患者。共有 1001 名患者对调查做出回应并表示同意；完成反流疾病诊断问卷的 998 名患者被纳入研究。其中，594 名无反流症状的患者被纳入最终分析。根据洛杉矶分类法对糜烂性食管炎的存在和严重程度进行分级。在胃镜检查期间通过弯曲样生物体（CLO）试验确定幽门螺杆菌（H. pylori）的活动性感染。
在 594 名无症状患者中，共有 14.5%（86/594）的患者内镜下有糜烂性食管炎的发现。在单因素分析中，男性和食管裂孔疝与 AEE 显著相关。阳性 CLO 试验呈趋势相关。基于多因素分析，与健康对照组相比，男性（比值比[OR]：2.32，95%置信区间[CI]：1.35-3.98）、食管裂孔疝（OR：4.48，95% CI：2.35-89.17）和阳性 CLO 试验（OR：0.57，95% CI：0.34-0.95）与 AEE 相关。
AEE 并不罕见，在无症状人群中占 14.5%。男性、食管裂孔疝和 H. pylori 感染是与 AEE 相关的因素。这些发现不仅有助于识别此类无症状患者，还为了解 H. pylori 感染、反流症状和糜烂性食管炎之间的关系提供了信息。
