Lúquez Mindiola Adán, Otero Regino William, Gómez Zuleta Martín
Fellow de Gastroenterología, Universidad Nacional de Colombia, Bogotá, Colombia.
Coordinador de Gastroenterología, Universidad Nacional de Colombia, Hospital Universitario Nacional, Bogotá, Colombia.
Rev Gastroenterol Peru. 2019 Jan-Mar;39(1):21-26.
Functional dyspepsia (FD) is a complex symptom. Currently there are multiple therapeutic options that are used for the management of these patients; however, FD therapies are based on symptomatic control and do not address the pathophysiological pathways involved in its development. The duodenum has been proposed as a key site to understand the complex pathophysiology involved in FD.
The aim of the study is to determine duodenal eosinophilia in patients with FD and establish the clinical-pathological correlation with the cardinal symptoms of dyspepsia.
Case-control study. Patients older than 18 years with dyspepsia according to the Rome IV criteria, and upper gastrointestinal endoscopy normal (FD group).Patients with iron deficiency anemia and chronic diarrhea (control group). Biopsies were taken in the stomach, duodenal bulb and second portion of duodenum. A sample size of 140 patients (70 patients in the FD group and 70 patients in the control group) was calculated. The collected information was described and analyzed by conventional statistical techniques.
243 patients were recruited. 84 patients were included in the FD group and 84 patients in the control group. 135 patients were women (80.3%). The mean age was 53.6 years (SD 14.9). Duodenal eosinophilia was found with significant difference in patients with early satiety (p=0.01). There was no difference in patients with postprandial fullness (p=0.63), epigastric pain or burning (p=0.26), gastroesophageal reflux symptoms (p=0.13), allergy and food intolerance (p=0.42) and smoking (p=0.28). There was no relationship between duodenal mastocytosis and early satiety (p=0.98), postprandial fullness (p=0.78), and epigastric pain or burning (p=0.82).
Duodenal eosinophilia was similar in FD and controls. In subgroup analysis, duodenal eosinophilia occurs in patients with early satiety.
功能性消化不良(FD)是一种复杂的症状。目前有多种治疗方法用于管理这些患者;然而,FD治疗基于症状控制,并未针对其发病机制中的病理生理途径。十二指肠已被认为是理解FD复杂病理生理学的关键部位。
本研究的目的是确定FD患者的十二指肠嗜酸性粒细胞增多情况,并建立其与消化不良主要症状的临床病理相关性。
病例对照研究。根据罗马IV标准患有消化不良且上消化道内镜检查正常的18岁以上患者(FD组)。缺铁性贫血和慢性腹泻患者(对照组)。在胃、十二指肠球部和十二指肠第二部取活检组织。计算样本量为140例患者(FD组70例患者,对照组70例患者)。收集的信息采用常规统计技术进行描述和分析。
招募了243例患者。FD组纳入84例患者,对照组纳入84例患者。135例患者为女性(80.3%)。平均年龄为53.6岁(标准差14.9)。在早饱患者中发现十二指肠嗜酸性粒细胞增多有显著差异(p=0.01)。在餐后饱胀(p=0.63)、上腹部疼痛或烧灼感(p=0.26)、胃食管反流症状(p=0.13)、过敏和食物不耐受(p=0.42)以及吸烟(p=0.28)方面无差异。十二指肠肥大细胞增多症与早饱(p=0.98)、餐后饱胀(p=0.78)和上腹部疼痛或烧灼感(p=0.82)之间无关联。
FD患者和对照组的十二指肠嗜酸性粒细胞增多情况相似。在亚组分析中,早饱患者出现十二指肠嗜酸性粒细胞增多。