Tatsuta M, Iishi H, Okuda S
Department of Gastrointestinal Oncology, Center for Adult Diseases, Osaka, Japan.
Dig Dis Sci. 1988 Jan;33(1):23-9. doi: 10.1007/BF01536626.
The association of cigarette smoking and other variables with the extent of the acid-secreting area and intestinal metaplasia were investigated by multivariate analysis. Studies were made by the endoscopic Congo red-methylene blue test developed in our hospital. In this test, acid-secreting areas and areas of intestinal metaplasia could be identified as discolored areas and areas staining blue with methylene blue, respectively. In multivariate analysis, the following variables were associated with a reduction in the size of the acid-secreting area in decreasing order of importance: the smoking index and age. The following factors had little or no influence on the size of the acid-secreting area: sex, and the consumption of aspirin and nonsteroidal, nonsalicylate, antiinflammatory drugs (NSNSAIDs). In general, in patients with a high smoking index, the acid-secreting area was small. Smoking had an influence in both younger and older patients and had more influence in females than in males. Multivariate analysis also shows that the following factors were associated with an increase in the area of intestinal metaplasia in decreasing order of importance: the extent of the acid-secreting area, age, and the smoking index. The following factors had little or no influence on the area of intestinal metaplasia: the consumption of aspirin and NSNSAIDs and sex. In general, in patients with little or no acid-secreting area, the area of intestinal metaplasia was extensive. These findings indicate that smoking is associated with reduction in the size of the acid-secreting area and so in development of intestinal metaplasia.
通过多变量分析研究了吸烟及其他变量与胃酸分泌区范围和肠化生的关系。采用我院开发的内镜刚果红-亚甲蓝试验进行研究。在该试验中，胃酸分泌区和肠化生区域可分别被识别为变色区和被亚甲蓝染成蓝色的区域。在多变量分析中，以下变量与胃酸分泌区面积减小相关，按重要性降序排列为：吸烟指数和年龄。以下因素对胃酸分泌区面积影响很小或无影响：性别、阿司匹林及非甾体、非水杨酸类抗炎药（NSNSAIDs）的使用。一般来说，吸烟指数高的患者胃酸分泌区较小。吸烟对年轻和老年患者均有影响，且对女性的影响大于男性。多变量分析还表明，以下因素与肠化生面积增加相关，按重要性降序排列为：胃酸分泌区范围、年龄和吸烟指数。以下因素对肠化生面积影响很小或无影响：阿司匹林及NSNSAIDs的使用和性别。一般来说，胃酸分泌区很小或无胃酸分泌区的患者，肠化生面积广泛。这些发现表明，吸烟与胃酸分泌区面积减小以及肠化生的发生有关。
