Prevalence of Eosinophilic Esophagitis in an Adult Population Undergoing Upper Endoscopy: A Prospective Study
Prevalence of Eosinophilic Esophagitis in an Adult Population Undergoing Upper Endoscopy: A Prospective Study
复制标题
DOI：
10.1016/j.cgh.2008.10.009
复制
发表时间：
2009-04-01
影响因子：
12.6
通讯作者：
Osgard, Eric M.
中科院分区：
文献类型：
--
作者：
Veerappan, Ganesh R.;Perry, Joseph L.;Osgard, Eric M.
背景与目的：嗜酸性食管炎(EoE)是以食道嗜酸性细胞浸润为特征的疾病。这项前瞻性研究的目的是确定接受择期上内窥镜检查的患者中EoE的患病率和临床预测因素。方法：我们招募了400名成人(中位年龄50岁，范围19-92岁)，从2007年3月到9月在一家三级保健军事医院接受了常规上消化道内窥镜检查。所有患者均完成症状问卷调查。所有的内窥镜检查结果都被记录下来。8例来自近端和远端食道的活检组织由盲人胃肠道病理学家进行了复查。2例患者出现EoE，如果出现20个嗜酸性粒细胞/高倍视野。结果：队列中EoE的患病率为6.5%(25/385；95%可信区间为4.3%-9.4%)。与EoE阴性患者相比，EoE阳性患者更有可能是配偶(80.0%比48.1%，P=.003)，50岁以下(72.0%比48.9%，P=.037)，有哮喘(32.0%比10.8%，P=.006)，食物嵌塞(32.0%比8.9%，P=.002)，吞咽困难(64.0%比38.1%，P=.018)，以及典型的内窥镜表现(环状，皱纹，斑块，或限制)EoE(所有P<；.01)。Logistic回归分析发现哮喘(优势比[OR]，4.48)、男性(OR，4.23)和食管环(OR，13.1)是EoE的独立预测因素。典型的EoE内窥镜表现的敏感性为72%(54%-88%)，特异性为89%(87%-90%)，阴性预测值为98%(95.6%-99.1%)。结论：接受上消化道内窥镜检查的门诊人群中EoE的患病率为6.5%。EoE患者的特征性表现包括男性性别、哮喘史，以及EoE在内窥镜下的典型表现，这是这种疾病过程的最强预测因素。
Background & Aims: Eosinophilic esophagitis (EoE) is characterized by eosinophilic infiltration of the esophagus. The purpose of this prospective study was to determine the prevalence and clinical predictors of EoE in patients undergoing elective upper endoscopy. Methods: We enrolled 400 consecutive adults (median age, 50 years; range, 19-92 years) who underwent routine upper endoscopy from March to September 2007 at a tertiary care military hospital. All patients completed a symptom questionnaire. All endoscopic findings were noted. Eight biopsies were obtained from proximal and distal esophagus and were reviewed by a blinded gastrointestinal pathologist. Patients had EoE if >= 20 eosinophils/high-power field were present. Results: The prevalence of EoE in this cohort was 6.5% (25/385; 95% confidence interval, 4.3%-9.4%). Compared with EoE negative patients, EoE positive patients were more likely to be mate (80.0% vs 48.1%, P = .003),younger than 50 years (72.0% vs 48.9%, P = .037), and have asthma (32.0% vs 10.8%, P = .006), a food impaction (32.0% vs 8.9%, P = .002), dysphagia (64.0% vs 38.1%, P = .018), and classic endoscopic findings (rings, furrows, plaques, or strictures) of EoE (all P < .01). Logistic regression identified asthma (odds ratio [OR], 4.48), male gender (OR, 4.23), and esophageal rings (OR, 13.1) as independent predictors of EoE. The presence of classic endoscopic findings of EoE had a sensitivity of 72% (54%-88%), specificity of 89% (87%-90%), and negative predictive value of 98% (95.6%-99.1%). Conclusions: The prevalence of EoE in an outpatient population undergoing upper endoscopy was 6.5%. The characteristic findings of EoE patients included male gender, history of asthma, and the presence of classic findings of EoE on endoscopy, which is the strongest predictor of this disease process.