胃黏膜肠化生的危险因素——60386例胃镜和病理分析  

Risk Factors of Gastric Mucosal Intestinal Metaplasia: Gastroscopy and Pathological Analysis of 60 386 Cases

作　　者：庄谦 周慧[1] 罗声政[1] 吴晓婉 董志霞[1] 夏幼辰 钱月琴 龚晓媛 宛新建[1] ZHUANG Qian;ZHOU Hui;LUO Shengzheng;WU Xiaowan;DONG Zhixia;XIA Youchen;QIAN Yueqin;GONG Xiaoyuan;WAN Xinjian(Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai ,201620)

机构地区：[1]上海交通大学附属第一人民医院消化内科

出　　处：《胃肠病学》2019年第7期427-429,共3页Chinese Journal of Gastroenterology

基　　金：上海市科学技术委员会科研计划项目(16411950404)

摘　　要：背景:胃黏膜肠化生为慢性萎缩性胃炎的病理表现之一,对其危险因素的早期干预有助于减缓萎缩性胃炎向胃癌发展的进程。目的:探讨胃黏膜肠化生的危险因素。方法:收集2013年1月—2018年9月至上海交通大学附属第一人民医院行胃镜检查的60386例患者的胃镜及其病理检查结果。采用Logistic回归分析探讨胃黏膜肠化生的危险因素。结果:15318例(25.4%)患者发生胃黏膜肠化生,6218例(10.3%)伴有胆汁反流。单因素Logistic回归分析显示,性别、年龄、胆汁反流、Hp感染均为胃黏膜肠化生的影响因素(P<0.05)。多因素Logistic回归分析显示,胆汁反流对胃黏膜肠化生无明显影响(OR=1.04,95%CI:0.97~1.11,P=0.25),性别(OR=1.13,95%CI:1.08~1.17,P<0.01)、年龄(OR=1.59,95%CI:1.56~1.61,P<0.01)、Hp感染(OR=1.25,95%CI:1.19~1.31,P<0.01)为胃黏膜肠化生的危险因素。结论:性别、年龄和Hp感染为胃黏膜肠化生的危险因素,尚不能认为胆汁反流对胃黏膜肠化生有影响。Background: Gastric mucosal intestinal metaplasia is one of the pathological manifestations of chronic atrophic gastritis. Early intervention of risk factors contributes to inhibiting the progression of atrophic gastritis to gastric cancer. Aims: To investigate the risk factors of gastric mucosal intestinal metaplasia. Methods: Results of gastroscopy and pathology of 60 386 patients from Jan. 2013 to Sept. 2018 at Shanghai General Hospital were collected. Logistic regression analysis was used to analyze the influencing factors of gastric mucosal intestinal metaplasia. Results: Gastric mucosal intestinal metaplasia was found in 15 318 (25.4%) patients, while bile reflux was found in 6 218 (10.3%) patients. Univariate Logistic regression analysis showed that gender, age, bile reflux and Hp infection were influencing factors of gastric mucosal intestinal metaplasia ( P <0.05). Multivariate Logistic regression analysis showed that bile reflux had no effect on gastric mucosal intestinal metaplasia (OR=1.04, 95% CI: 0.97-1.11, P =0.25), however, gender (OR= 1.13 , 95% CI: 1.08-1.17, P <0.01), age (OR=1.59, 95% CI: 1.56-1.61, P <0.01) and Hp infection (OR= 1.25 , 95% CI: 1.19-1.31, P <0.01) were risk factors of gastric mucosal intestinal metaplasia. Conclusions: Gender, age and Hp infection are risk factors of gastric mucosal intestinal metaplasia. Bile reflux cannot be considered as the influencing factor of intestinal metaplasia of gastric mucosa.

关 键 词：胃黏膜 化生 胆汁反流 危险因素 LOGISTIC模型 

分 类 号：R735.2[医药卫生—肿瘤]