Nam Kwangwoo, Shin Jeong Eun, Kim Sung Eun, Baik Gwang Ho, Choi Sang Hyeon, Lee Ju Yup, Park Kyung Sik, Joo Young-Eun, Myung Dae-Seong, Kim Hyeon Ju, Song Hyun Joo, Choi Suck Chei, Kim Hyun Jin, Kim Hyun Young, Kim Nayoung
a Department of Internal Medicine , Dankook University College of Medicine , Cheonan , South Korea.
b Department of Internal Medicine , Kosin University College of Medicine , Busan , South Korea.
Scand J Gastroenterol. 2018 Aug;53(8):910-916. doi: 10.1080/00365521.2018.1487992. Epub 2018 Aug 31.
The prevalence of upper gastrointestinal disease is expected to change following advances in socioeconomic status and improved hygiene in Korea. The aim of this study was to investigate the recent trends in upper gastrointestinal diseases based on endoscopic findings and Helicobacter pylori (H. pylori) seroprevalence in subjects undergoing health check-up at tertiary centers in Korea.
A multicenter cross-sectional study was conducted at nine healthcare centers between September 2016 and June 2017. The subjects were evaluated using questionnaires, upper endoscopy and H. pylori serology tests. The results were compared with previous data in our study group obtained from eight tertiary healthcare centers in 2011 (n = 4023).
In total, we prospectively enrolled 2504 subjects undergoing health check-up. The prevalence of reflux esophagitis (RE) was 9.7%, which showed an increasing but insignificant trend since 2011 (8.8%). The prevalence of active and healing-stage benign gastric ulcer and duodenal ulcer (DU) was 1.6% and 1.2%, respectively, which confirmed a significant decrease since 2011 (4.1%; p < .001 and 2.2%; p = .005, respectively). The prevalence of gastric cancer was 0.5%, representing an increasing trend since 2011 (0.12%; p = .003). H. pylori seroprevalence was 51.3%, which significantly decreased from 2011 (59.8%; p < .001). In multivariate analysis, H. pylori seropositivity was a significant risk factor for DU (p < .001), whereas a significant protective factor against RE (p < .001).
The significant decrease of H. pylori seroprevalence in the past five years altered the incidence of upper gastrointestinal disease.
随着韩国社会经济地位的提高和卫生条件的改善，预计上消化道疾病的患病率会发生变化。本研究旨在基于韩国三级医疗中心健康体检受检者的内镜检查结果和幽门螺杆菌（H. pylori）血清流行率，调查上消化道疾病的近期趋势。
2016年9月至2017年6月期间，在9个医疗中心进行了一项多中心横断面研究。通过问卷调查、上消化道内镜检查和幽门螺杆菌血清学检测对受检者进行评估。将结果与我们研究组2011年从8个三级医疗中心获得的先前数据（n = 4023）进行比较。
我们共前瞻性纳入了2504名进行健康体检的受检者。反流性食管炎（RE）的患病率为9.7%，自2011年（8.8%）以来呈上升趋势，但无统计学意义。活动期和愈合期良性胃溃疡及十二指肠溃疡（DU）的患病率分别为1.6%和1.2%，自2011年以来显著下降（分别为4.1%；p < 0.001和2.2%；p = 0.005）。胃癌的患病率为0.5%，自2011年以来呈上升趋势（0.12%；p = 0.003）。幽门螺杆菌血清流行率为51.3%，较2011年显著下降（59.8%；p < 0.001）。多因素分析显示，幽门螺杆菌血清阳性是DU的显著危险因素（p < 0.001），而对RE是显著保护因素（p < 0.001）。
过去五年幽门螺杆菌血清流行率的显著下降改变了上消化道疾病的发病率。
