洛阳地区Barrett’s食管的发病情况、内镜和病理学特点

The prevalence,endoscopic and pathological characteristies of Barrett's esophagus in Luoyang

目的探讨洛阳地区一组Barrett’s食管（BE）的发病情况、内镜和病理学特点及其与幽门螺杆菌（H．pylori）感染的关系。方法采用普通胃镜检查结合病理检查结果，对洛阳地区有消化道症状的一组BE患者进行分析，同时采用尿素[^14C]呼气试验药盒检查H·pylori感染对BE发病学的影响。结果2006年8月～2007年4月共有593例接受胃镜检查，有22例诊断为BE，BE发病率为3．71％；以短段、舌型发病率最高，分别占81．81％和77．27％；7例（31．8％）有典型反流症状；伴有低度异型性增生3例（13．64％），重度异型性增生1例（4．55％），并发腺癌1例（4．55％），其中伴有重度异型性增生的1例随访1年后并发腺癌；对其中的10例进行H．pylori检查，阳性率为90％。结论洛阳地区BE发病率较高，以短段、舌型为主，有典型反流症状者较少，伴有异型性增生、腺癌者及并发H．pylori感染者常见。

Objectives To investigate the incidence, endoscopic and pathological characteristies of Barrett＇ s esophagus （BE） and the relation between BE and H. priori infection in a group of patients in Luoyang. Methods A group of patients with BE were analyzed owned gastrointestinal symptom in Luoyang according to results from ordinary gastroscopy and hematoxylin-eosin straining pathology, meanwhile, effect of H. priori infection to BE pathogenesis was studied by the kit for [ ^14C]Urea Breath Test. Results BE was 3.71% （22/593） of total patients conducted endoscopy check between August 2006 and April 2007, and short segment and tongue type BE were most common （81.81% , 77.27% ）. Only 31.8% of BE patients had typical reflux symptoms. Low grade dysplasia was detected in 13.64% of BE, hight grade dysplasia in 4.55% , and adencarcinoma in 4.55%. Adencarcinoma was found in one case of hight grade dysplasia after follow up one year. Ninty percent of BE patients were infected with H. priori. Conclusions Incidence of BE in Luoyang is high. Most of BE are short segment and tongue type, and have no typical reflux symtoms. It is very common in BE patients accompanied with dysplasia, adencarcinoma and H. priori infection.