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反流和/或消化不良症状患者的内镜及组织学检查结果和幽门螺杆菌感染状况:一项近期的希腊队列研究

Endoscopic and histological findings and Helicobacter pylori status in patients with reflux and/or dyspeptic symptoms: a recent Greek cohort study.

作者信息

Vasiliou Charalampos, Xiromeritou Vasiliki, Kafiri Georgia, Papatheodoridis George

机构信息

Charalampos Vasiliou, MD, is Specialist, Gastroenterology Department, Ippokration University General Hospital, Athens, Greece. Vasiliki Xiromeritou, PhD, MD, is Consultant, Gastroenterology Department, Ippokration University General Hospital, Athens, Greece. Georgia Kafiri, PhD, MD, is Director, Pathology Department, Ippokration University General Hospital, Athens, Greece. George Papatheodoridis, PhD, MD, is Associate Professor, Internal Medicine Department, Ippokration University General Hospital, Athens, Greece.

出版信息

Gastroenterol Nurs. 2014 Nov-Dec;37(6):431-8. doi: 10.1097/SGA.0000000000000075.

Abstract

The associations between symptoms and endoscopic findings have not been clearly defined. We aimed to assess the associations of reflux dyspepsia and/or symptoms with specific endoscopic findings, histological findings, as well as the presence of Helicobacter pylori infection and its CagA subtype. A total of 160 patients with dyspeptic and/or reflux symptoms underwent upper gastrointestinal endoscopy. Type and severity of symptoms during the last week were evaluated according to a questionnaire. Biopsy specimens were obtained from the esophagus and stomach. Presence of H. pylori was tested in tissue specimens and its CagA subtype in serum samples. Of the 160 patients, 70% reported reflux, 73.7% dyspeptic symptoms, while 43.7% of patients reported both. The major endoscopic findings were chronic gastritis (n = 134), hiatal hernia (n = 98), and erosive esophagitis (n = 55). There was no significant difference in the endoscopic findings of patients with and without dyspepsia except for the subgroup of ulcer-like dyspeptic patients with significantly more frequently erosive peptic lesions (25% vs. 8.7%, p = .01). Patients with reflux symptoms had more frequently erosive esophagitis (42.9% vs. 14.6%, p = .001). Types of histological lesions, presence of H. pylori infection, and its cagA subtype had no statistical difference with presence or not of any symptoms. Patients with compared with those without reflux or ulcer-like dyspeptic symptoms had endoscopically more frequently erosive esophagitis and erosive peptic lesions, respectively. On the contrary, there is no statistical difference regarding the histological lesions, the presence of H. pylori, and its cagA subtype in all subgroups of patients.

摘要

症状与内镜检查结果之间的关联尚未明确界定。我们旨在评估反流性消化不良和/或症状与特定内镜检查结果、组织学检查结果以及幽门螺杆菌感染及其CagA亚型存在情况之间的关联。共有160例有消化不良和/或反流症状的患者接受了上消化道内镜检查。根据问卷评估上周症状的类型和严重程度。从食管和胃获取活检标本。检测组织标本中幽门螺杆菌的存在情况以及血清样本中其CagA亚型。在这160例患者中,70%报告有反流,73.7%有消化不良症状,而43.7%的患者两者都有报告。主要的内镜检查结果为慢性胃炎(n = 134)、食管裂孔疝(n = 98)和糜烂性食管炎(n = 55)。除了溃疡样消化不良患者亚组中糜烂性消化性病变明显更常见(25%对8.7%,p = 0.01)外,有消化不良和无消化不良患者的内镜检查结果无显著差异。有反流症状的患者糜烂性食管炎更常见(42.9%对14.6%,p = 0.001)。组织学病变类型、幽门螺杆菌感染的存在情况及其cagA亚型与任何症状的有无均无统计学差异。与无反流或溃疡样消化不良症状的患者相比,有反流或溃疡样消化不良症状的患者内镜下分别更常出现糜烂性食管炎和糜烂性消化性病变。相反,在所有患者亚组中,关于组织学病变、幽门螺杆菌的存在情况及其cagA亚型均无统计学差异。

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