中国西北地区Barrett食管流行病学及危险因素调查研究

Prevalence and risk factors of Barrett's esophagus in Northwest China

目的:调查我国西北地区Barrett食管(BE)的流行病学状况及危险因素。方法:2008年9月至2009年2月,在我国西北地区不同省市的四个主要教学医院的内镜中心行健康检查或者有上消化道症状的年龄大于18岁的患者选为研究对象。所有研究对象接受包括危险因素在内的胃食管反流病(GERD)问卷调查及内镜检查。当胃食管反流症状总积分≥12分时诊断为GERD。对内镜疑似化生食管取活检,经病理学检查发现有特殊的肠化生时诊断为BE。结果:在12265例调查对象中,142例(男性91例,女性51例)诊断为BE,其中32例发生在GERD中,110例发生在非GERD中。BE在内镜检查患者中的发病率为1.16%,平均年龄为51.3±12.6岁。BE在GERD和非GERD中的发病率有显著性差异,而在汉族和非汉族中的发病率无显著性差异。多因素回归分析显示男性性别、年龄、GERD、食管裂孔疝、饮酒、水果蔬菜缺乏可能为危险因素,而饮茶为保护因素。结论:我国西北地区BE在内镜检查患者中的发病率为1.16%,在GERD和非GERD中分别为6.06%和0.94%。老年男性、GERD、食管裂孔疝、饮酒、水果蔬菜缺乏可能危险因素,喝茶可能为保护因素。

Objective： To investigate the prevalence and possible risk factors of Barrett＇s esophagus （BE） in Northwest China. Methods： Patients older than 18 years who underwent regular health check-up or had upper gastrointestinal symptoms in the endoscopy centers of four maior teaching hospitals located in four different provinces of Northwest China from September 2008 to February 2009 were included in the study. A face-to-face questionnaire for gastroesophageal reflux disease （GERD） and upper digestive tract endoscopy was done. Endoscopic signs of columnar-lined esophagus were defined as mucosal tongue or an upward shift of the squamocolumnar junction. BE was diagnosed by pathological examination when specialized intestinal metaplasia was detected histologically in suspected columnar-lined esophagus. Results： A total of 142 out of 12265 cases were diagnosed BE histologically, There were 91 male and 51 female, 32 were diagnosed in GERD and 110 in non-GERD. The prevalence of BE in the population was 1.16% with mean age of 51.3±4-12.6 years old. The incident of BE in patients with GERD was significantly higher than patients without GERD. There was no significant difference between Han Chinese and nonHan Chinese. Multivariate regression analysis showed that the potential risk factors of BE were gender, age, GERD, esophageal hiatal hernia,drinking alcohol, deficient of vegetable and fruit, while drinking tea was a protec tive factor. Conclusion： The prevalence of BE in the population is 1.16% in Northwest China and it is 6.06% in patients with GERD. The potential risk factors of BE were old male, GERD, esophageal hiatal hernia, drinking alcohol, deficient of vegetable and fruit, while drinking tea is a protective factor .