无警告症状的消化不良患者胃镜检查的价值

Value of gastroscopy in dyspepsia patients without warning symptoms

目的探讨胃镜检查在无警告症状的消化不良患者中的临床诊断价值.方法以问卷调查形式,收集因消化不良进行门诊胃镜检查患者的资料,包括人口学资料、症状,并结合胃镜及病理组织学检查结果进行分析.结果共纳入521例患者,胃镜检查表现为主要病变的有163例(31.3%),包括糜烂性食管炎95例(18.2%)、消化性溃疡65例(12.5%)、上消化道恶性肿瘤3例(0.58%).多因素Logistic回归分析显示,男性、上腹痛、幽门螺杆菌(Helicobacter pylori, H. pylori)感染是胃镜检查结果为主要病变的独立危险因素.结论消化不良是消化科门诊患者主要就诊原因之一,对于这部分病人即使没有任何警告症状仍应行胃镜检查,特别是男性、有上腹痛症状以及H. pylori感染患者,以防遗漏消化性溃疡、反流性食管炎甚至恶性肿瘤等器质性疾病.

AIM To assess the clinical diagnostic value of gastroscopy in dyspepsia patients without warning symptoms Clinical data for patients undergoing gastroscopy for dyspepsia, including demographic information and symptoms, were collected with questionnaires and analyzed by combining with gastroscopic and histopathological findings. RESULTS A Total of 521 cases were enrolled, of which 163 （31.3%） had primary lesions that were detectable by gastroscopy, including 95 （18.2%） with erosive esophagitis, 65 （12.5%） with peptic ulcers, and 3 （0.58%） with upper malignancy. Multivariate Logistic regression analysis showed that male gender, epigastric pain, and Helicobacter pylori （H. pylori） infection were independent risk factors for the presence of primary lesions detectable by gastroscopy. Dyspepsia is one of the main reasons for outpatients seeking medical treatment in Department of Gastroenterology. Gastroscopy is a necessity for these patients even without any warning symptoms, which is especially true for male patients, patients with epigastric pain or H. pylori infection, in order to prevent the omission of organic diseases such as peptic ulcer, reflux esophagitis, and even upper malignancy.