Nesland A, Berstad A
Scand J Gastroenterol. 1985 Mar;20(2):222-8. doi: 10.3109/00365528509089661.
A specified endoscopic picture, consisting of standing prepyloric mucosal folds, injection, and erosions, is denoted erosive prepyloric changes (EPC) and is divided into three grades. In a prospective study in 1001 patients referred for routine upper endoscopy, active EPC (grades 2 and 3) was found in 25.8%, rising to 32.2% in dyspeptic patients with non-ulcer conditions. EPC was significantly more frequent in those below than those above 50 years of age, the male to female ratio being 1.1. In 34.5% of the EPC patients, EPC was an isolated finding. Maximal acid output was, on an average, significantly lower in patients with EPC than in duodenal ulcer patients and similar to that of healthy subjects. Non-ulcer conditions were significantly more frequent, and ulcer in general significantly less frequent, in the EPC group than in a randomly selected control group without EPC. In 34 asymptomatic volunteers the frequency of EPC was 17.6%, significantly lower than in patients of comparable age with non-ulcer conditions. The findings indicate that EPC is related to non-ulcer dyspepsia. The recognition of this condition may lead to a more accurate definition of a patient group with ulcer-like symptoms, without ulcer, and thus, in turn, result in more efficient treatment procedures.
一种特定的内镜图像，由幽门 prepyloric 黏膜皱襞、注射和糜烂组成，被称为糜烂性幽门 prepyloric 改变（EPC），并分为三个等级。在一项对 1001 例因常规上消化道内镜检查而转诊的患者进行的前瞻性研究中，发现活动性 EPC（2 级和 3 级）的发生率为 25.8%，在非溃疡性消化不良患者中升至 32.2%。EPC 在 50 岁以下人群中比 50 岁以上人群中更为常见，男女比例为 1.1。在 34.5%的 EPC 患者中，EPC 是唯一的发现。EPC 患者的最大酸分泌量平均显著低于十二指肠溃疡患者，与健康受试者相似。与随机选择的无 EPC 的对照组相比，EPC 组中非溃疡性疾病明显更常见，而溃疡总体上明显更少见。在 34 名无症状志愿者中，EPC 的发生率为 17.6%，明显低于年龄相仿的非溃疡性疾病患者。这些发现表明 EPC 与非溃疡性消化不良有关。认识到这种情况可能会更准确地定义一组有溃疡样症状但无溃疡的患者群体，从而反过来导致更有效的治疗程序。
