系统评价与荟萃分析：胃食管反流症状个体发生巴雷特食管的危险因素。

Systematic review with meta-analysis: risk factors for Barrett's oesophagus in individuals with gastro-oesophageal reflux symptoms.

机构信息

Gastroenterology and Endoscopy Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

出版信息

Aliment Pharmacol Ther. 2021 May;53(9):968-976. doi: 10.1111/apt.16321. Epub 2021 Mar 11.

DOI:10.1111/apt.16321

PMID:33705573

Abstract

BACKGROUND

Gastro-oesophageal reflux is considered the main risk factor for Barrett's oesophagus. The role of other potential risk factors for the development of Barrett's oesophagus in patients with gastro-oesophageal reflux symptoms is controversial.

AIMS

To perform a systematic review and meta-analysis examining risk factors in development of Barrett's oesophagus.

METHODS

Medline, Embase and Embase Classic were searched (until December 2020) to identify cross-sectional studies reporting prevalence of Barrett's oesophagus based on presence of one or more proposed risk factors in individuals with gastro-oesophageal reflux symptoms. Prevalence of Barrett's oesophagus was compared according to presence or absence of each risk factor in individuals with gastro-oesophageal reflux symptoms.

RESULTS

Of 7164 citations evaluated, 13 studies reported prevalence of Barrett's oesophagus in 11 856 subjects. Pooled prevalence of histologically confirmed Barrett's oesophagus in individuals with gastro-oesophageal reflux symptoms in all studies was 7.0% (95% CI 4.8% to 9.6%). Prevalence was higher in subjects with hiatal hernia (OR 2.74; 95% CI 1.58 to 4.75) and in those who drank alcohol (OR 1.51; 95% CI 1.17 to 1.95). Other features including non-steroidal anti-inflammatory drugs and/or aspirin use (OR 1.19; 95% CI 1.00 to 1.42), smoking (OR 1.14; 95% CI 0.96 to 1.35) or obesity (OR 1.10; 95% CI 0.92 to 1.33) were not significantly associated with Barrett's oesophagus.

CONCLUSIONS

The prevalence of Barrett's oesophagus in individuals with gastro-oesophageal reflux symptoms was higher in those who drank alcohol, although this association was modest. The strongest association found was between hiatal hernia and Barrett's oesophagus. Other potential risk factors assessed in this study did not appear to be associated with presence of Barrett's oesophagus among individuals with gastro-oesophageal symptoms.

摘要

背景

胃食管反流被认为是 Barrett 食管的主要危险因素。在有胃食管反流症状的患者中，其他潜在的 Barrett 食管发生危险因素的作用仍存在争议。

目的

进行系统评价和荟萃分析，以检查 Barrett 食管发生的危险因素。

方法

检索 Medline、Embase 和 Embase Classic（截至 2020 年 12 月），以确定基于有或无胃食管反流症状个体中存在一个或多个提出的危险因素，报告 Barrett 食管患病率的横断面研究。根据有或无胃食管反流症状个体中存在的每个危险因素，比较 Barrett 食管的患病率。

结果

在评估的 7164 篇引文中有 13 项研究报告了 11856 例患者的 Barrett 食管患病率。所有研究中胃食管反流症状患者的组织学证实 Barrett 食管的汇总患病率为 7.0%（95%CI：4.8%至 9.6%）。在有食管裂孔疝（OR 2.74；95%CI：1.58 至 4.75）和饮酒者（OR 1.51；95%CI：1.17 至 1.95）中患病率更高。其他特征包括非甾体抗炎药和/或阿司匹林使用（OR 1.19；95%CI：1.00 至 1.42）、吸烟（OR 1.14；95%CI：0.96 至 1.35）或肥胖（OR 1.10；95%CI：0.92 至 1.33）与 Barrett 食管无显著相关性。