Pantai Hospital Kuala Lumpur, Department of Medicine, Kuala Lumpur Malaysia.
Pantai Hospital Kuala Lumpur, Pantai Premier Pathology, Kuala Lumpur Malaysia.
Med J Malaysia. 2022 Jul;77(4):494-499.
Duodenal eosinophilia is postulated to play a key role in the pathogenesis of functional dyspepsia, a common condition responsible for considerable impairment of quality of life. Our objective was to evaluate the relative strength of the associations between duodenal eosinophilia, functional dyspepsia, symptomatic erosive gastroesophageal reflux disease (GERD), the presence of co-morbidities, and a number of other variables.
Eosinophil counts of archived endoscopic duodenal biopsies of 289 subjects were determined by a pathologist blinded to the clinical data. Duodenal eosinophilia was defined by a count of more than 15 per 5 high power fields. Clinical charts were reviewed by a gastroenterologist blinded to the histology review.
In the study sample, the primary diagnosis was functional dyspepsia (undifferentiated by subtypes) in 45, symptomatic erosive GERD in 29, gall stone disease in 17, irritable bowel syndrome in 23, and an alternative or undetermined diagnosis in 175 subjects, respectively. On logistic regression analyses, eosinophil counts were positively associated with symptomatic erosive GERD (Odds Ratio, OR 1.03, 95% Confidence Interval, 95%CI: 1.00, 1.05; p=0.035) but not functional dyspepsia. Pre-defined duodenal eosinophilia was associated with symptomatic erosive gastro-oesophageal reflux disease (OR 3.36, 95%CI 1.18,-9.60; p=0.023), the presence of co-morbidities (OR 2.00, 95%CI 1.10, 3.62; p=0.022), and Chinese (as compared to Malay and Indian) ethnicity but not with either functional dyspepsia, irritable bowel syndrome, gallstone disease, Helicobacter pylori infection, or gender.
Duodenal eosinophilia was associated with symptomatic erosive GERD, the presence of co-morbidities, and Chinese ethnicity but not with undifferentiated functional dyspepsia.
十二指肠嗜酸性粒细胞增多被认为在功能性消化不良的发病机制中起关键作用，这是一种常见的病症，会导致生活质量的严重下降。我们的目的是评估十二指肠嗜酸性粒细胞增多、功能性消化不良、有症状的侵蚀性胃食管反流病（GERD）、共存疾病的存在以及其他一些变量之间的关联强度。
由一位对临床数据不知情的病理学家确定了 289 名患者的内镜十二指肠活检的嗜酸性粒细胞计数。通过计数每 5 高倍视野超过 15 个嗜酸性粒细胞来定义十二指肠嗜酸性粒细胞增多。对临床图表的审查由一位对组织学审查不知情的胃肠病学家进行。
在研究样本中，主要诊断分别为功能性消化不良（未细分亚型）45 例、有症状的侵蚀性 GERD29 例、胆石症 17 例、肠易激综合征 23 例，以及其他或未明确诊断 175 例。在逻辑回归分析中，嗜酸性粒细胞计数与有症状的侵蚀性 GERD 呈正相关（优势比，OR 1.03，95%置信区间，95%CI：1.00，1.05；p=0.035），但与功能性消化不良无关。预定义的十二指肠嗜酸性粒细胞增多与有症状的侵蚀性胃食管反流病（OR 3.36，95%CI 1.18，-9.60；p=0.023）、共存疾病的存在（OR 2.00，95%CI 1.10，3.62；p=0.022）和华裔（与马来裔和印度裔相比）有关，但与功能性消化不良、肠易激综合征、胆石症、幽门螺杆菌感染或性别无关。
十二指肠嗜酸性粒细胞增多与有症状的侵蚀性 GERD、共存疾病的存在和华裔有关，但与未分化的功能性消化不良无关。
