Association between Helicobacter pylori and Barrett's esophagus: a case-control study.

Association between Helicobacter pylori and Barrett's esophagus: a case-control study.
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DOI:
10.1038/ajg.2013.443
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发表时间:
2014-03
影响因子:
9.8
通讯作者:
El Serag, Hashem B.
El Serag, Hashem B.
中科院分区:
医学1区
文献类型:
--
作者:
Fischbach, Lori A.;Graham, David Y.;Kramer, Jennifer R.;Rugge, Massimo;Verstovsek, Gordana;Parente, Paola;Alsarraj, Abeer;Fitzgerald, Stephanie;Shaib, Yasser;Abraham, Neena S.;Kolpachi, Anna;Gupta, Swapna;Vela, Marcelo F.;Velez, Maria;Cole, Rhonda;Anand, Bhupinderjit;El Serag, Hashem B.

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幽门螺杆菌和巴雷特食管(BE)之间的估计关联在以往的研究中是异质的。在这项研究中,我们的目的是检查之间的关联H。pylori和BE,并确定可能解释或改变这种关联的因素。我们进行了一项病例对照研究,其中我们使用从初级保健诊所招募的筛查结肠镜检查对照作为我们的主要对照组,以尽量减少选择偏倚。所有参与者均接受了食管胃镜检查和胃标测活检。我们使用逻辑回归获得比值比(OR)和95%置信区间(CI)来估计H。pylori和BE,同时控制混杂因素。我们确定了218例病例和439例对照。H. pylori和BE在控制了年龄和白色人种后的差异为0.55(95%CI:0.35-0.84)。我们观察到,在胃体萎缩或每周使用抗分泌药物≥1次(被认为是降低胃酸度的因素)的参与者中,存在更强的负相关性(OR:0.28; 95% CI:0.15,0.50),而在没有这些因素的患者中则无负相关性(OR:1.32; 95% CI:0.66,2.63)。H.幽门螺杆菌感染和BE风险降低似乎发生在有可能降低胃酸度因素的患者中(胃体萎缩或每周至少服用一次抗分泌药物)。
The estimated association between Helicobacter pylori and Barrett's esophagus (BE) has been heterogenous across previous studies. In this study, we aimed to examine the association between H. pylori and BE and to identify factors that may explain or modify this association. We conducted a case–control study in which we used screening colonoscopy controls recruited from primary care clinics as our primary control group in order to minimize selection bias. All participants underwent an esophagogastroduodenoscopy with gastric mapping biopsies. We used logistic regression to obtain odds ratios (ORs) and 95 % confidence intervals (CIs) to estimate the association between H. pylori and BE while controlling for confounders. We identified 218 cases and 439 controls. The overall OR for the association between H. pylori and BE after controlling for age and white race was 0.55 (95 % CI: 0.35–0.84). We observed an even stronger inverse association (OR: 0.28; 95 % CI: 0.15, 0.50) among participants with corpus atrophy or antisecretory drug use ≥1 time per week (factors thought to lower gastric acidity), and no inverse association in patients without these factors (OR: 1.32; 95 % CI: 0.66, 2.63). The association between H. pylori and a decreased risk for BE appears to occur in patients with factors that would likely lower gastric acidity (corpus atrophy or taking antisecretory drugs at least once a week).
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发表时间: 2012-06
期刊: Helicobacter
影响因子: 4.4
作者:
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