胃食管阀瓣异常与贲门息肉发生相关性的回顾性病例对照研究

The correlation between cardiac polyps and abnormal gastroesophageal flap valve:a retrospective case-control

目的探讨贲门息肉的发生与胃食管阀瓣(gastroesophageal flapvalve,GEFV)的相关性。方法回顾性收集2016年1月1日至2021年12月31日在扬州大学附属医院就诊的349例贲门息肉患者(贲门息肉组)的临床、内镜及病理资料,根据倾向性评分匹配同期相同例数的非贲门息肉患者(非贲门息肉组)作为对照,对比分析两组的临床、内镜及组织病理资料。结果倾向性评分匹配后,贲门息肉组与非贲门息肉组各296例患者,两组在吸烟、反酸、烧心、幽门螺杆菌感染、胆汁反流、反流性食管炎、贲门炎方面差异均无统计学意义(P>0.05),两组间具有可比性。与非贲门息肉组相比,GEFVⅡ级患者(OR=3.046,95%CI:2.100~4.419,P<0.001)与GEFVⅢ级患者(OR=4.20295%CI:2.299~7.681,P<0.001)发生贲门息肉风险增加。且与非贲门息肉组相比,GEFV异常患者发生贲门息肉风险增加(OR=2.822,95%CI:1.615~4.931,P<0.001)。GEFV异常与贲门息肉部位相关(χ^(2)=22.169,P=0.003),与贲门息肉大小、数目、形态、周围黏膜肠化及上皮内瘤变无明显相关(P>0.05)。结论贲门息肉的发生与GEFV相关,GEFV异常患者更容易发生贲门息肉。

Objective To investigate the correlation between cardiac polyps and gastroesophageal flap valve(GEFV).Methods The clinical,endoscopic and pathological data of 349 patients with cardiac polyps(the cardiac polyp group)visiting Affiliated Hospital of Yangzhou University from January 1,2016 to December 31,2021 were retrospectively collected,and the same number of non-cardiac polyp patients(the non-cardiac polyp group)were matched in the same period as control according to the propensity score.The clinical,endoscopic and pathological data of the two groups were compared.Results After matching with propensity score,there were 296 patients in each group,with no significant differences in smoking,acid reflux,heartburn,Helicobacter pylori infection,bile reflux,reflux esophagitis or pancreatitis between the two groups(P>0.05).Compared with the non-cardiac polyp group,the risk of cardiac polyps increased in GEFVⅡpatients(OR=3.046,95%CI:2.100-4.419,P<0.001)and GEFVⅢpatients(R=4.202,95%CI:2.299-7.681,P<0.001).Compared with the non-cardiac polyp group,the risk of cardiac polyps increased in patients with GEFV abnormalities(OR=2.822,95%CI:1.615-4.931,P<0.001).GEFV abnormalities was associated with the cardiac polyp site(χ^(2)=22.169,P=0.003)and was not significantlyy associated with cardiac polyp size,number,morphology,intestinla ml etaplasia of the surrounding mucosa or intraepithelial neoplasia(P>0.05).Conclusion The occurrence of cardiac polyps is related to GEFV,and the patients with GEFV abnormalities are more likely to develop cardiac polyps.