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食管上段异位胃黏膜患者症状的危险因素

Risk Factors for Symptoms in Patients With Heterotopic Gastric Mucosa in the Upper Esophagus.

作者信息

Wang Zhenxiang, Chen Ying, Sun Huihui, Xiong Jie, Zeng Yu, Chen Ye, Zhang Yan, Dong Zhiyu, Wang Junwen, Duan Guangbing, Li Bo, Qian Xue, Sun Kejing, Zhan Tingting, Jiang Yuanxi, Xu Shuchang

机构信息

Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

出版信息

Gastroenterol Res Pract. 2025 Jan 9;2025:7658517. doi: 10.1155/grp/7658517. eCollection 2025.

Abstract

This study is aimed at comparing the clinical characteristics and histological types of symptomatic and asymptomatic patients with heterotopic gastric mucosa in the upper esophagus (HGMUE) and exploring the factors influencing the occurrence and severity of laryngopharyngeal reflux (LPR) symptoms in these patients. HGMUE is a potential cause of LPR symptoms. This retrospective analysis evaluated 70 patients with HGMUE using a detailed questionnaire. Clinical, histological, high-resolution manometry, and 24-h pH impedance monitoring data were compared between symptomatic ( = 49) and asymptomatic ( = 21) patients. : The diameter of HGMUE was significantly larger in the symptomatic group ( < 0.05), and the incidence of LPR symptoms increased with larger diameter grades; male patients were more likely to have LPR symptoms. The incidence of LPR symptoms varied significantly across histological classifications, being highest in patients with the fundic type ( = 6.64, < 0.05). Binary logistic regression analysis identified sex and histological type as risk factors for LPR symptoms, with odds ratios of 8.996 (95% confidence interval (CI): 1.350-59.962) and 8.493 (95% CI: 1.486-48.522), respectively. The mean nocturnal baseline impedance (MNBI) in the upper esophagus was significantly lower in the symptomatic group (1676.82 ± 739.09  vs. 2441.01 ± 604.11 ; < 0.05). Clinical and demographic characteristics did not significantly affect the severity of LPR symptoms. The diameter, histological type, and sex of patients are risk factors for the occurrence of LPR symptoms in patients with HGMUE. More attention should be paid to patients with these factors. The MNBI is an effective indicator of the symptoms and treatment.

摘要

本研究旨在比较有症状和无症状的食管上段异位胃黏膜(HGMUE)患者的临床特征和组织学类型,并探讨影响这些患者喉咽反流(LPR)症状发生及严重程度的因素。HGMUE是LPR症状的一个潜在原因。本回顾性分析使用详细问卷评估了70例HGMUE患者。比较了有症状(n = 49)和无症状(n = 21)患者的临床、组织学、高分辨率测压及24小时pH阻抗监测数据。结果:有症状组HGMUE的直径显著更大(P < 0.05),且LPR症状的发生率随直径分级增大而增加;男性患者更易出现LPR症状。LPR症状的发生率在不同组织学分类中差异显著,在胃底型患者中最高(P = 6.64,P < 0.05)。二元逻辑回归分析确定性别和组织学类型为LPR症状的危险因素,优势比分别为8.996(95%置信区间(CI):1.350 - 59.962)和8.493(95%CI:1.486 - 48.522)。有症状组食管上段的平均夜间基础阻抗(MNBI)显著更低(1676.82 ± 739.09Ω vs. 2441.01 ± 604.11Ω;P < 0.05)。临床和人口统计学特征对LPR症状的严重程度无显著影响。患者的直径、组织学类型和性别是HGMUE患者发生LPR症状的危险因素。对有这些因素的患者应给予更多关注。MNBI是症状及治疗的有效指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c94/11737899/0f82f4df61df/GRP2025-7658517.001.jpg

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