ARCH PATHOL LAB MED:食管远端组织活检中的胰腺腺泡化生与慢性非甾体抗炎药物的使用有关

2019-05-09 不详 网络

目前对于胰腺腺泡化生(PAM)发生在食管远端/食管胃交界处的原因仍有争议。尽管一些研究人员认为它是先天性的,但另一些认为它是由于胃贲门炎症而引起的,最近一项基于大鼠的研究表明,它是由于慢性质子泵抑制剂的使用而引发的。本研究的目的是确定慢性质子泵抑制剂的使用与人类PAM之间是否存在相关性。还研究了几种临床和病理因素与PAM的关系。

目前对于胰腺腺泡化生(PAM)发生在食管远端/食管交界处的原因仍有争议。尽管一些研究人员认为它是先天性的,但另一些认为它是由于贲门炎症而引起的,最近一项基于大鼠的研究表明,它是由于慢性质子泵抑制剂的使用而引发的。本研究的目的是确定慢性质子泵抑制剂的使用与人类PAM之间是否存在相关性。还研究了几种临床和病理因素与PAM的关系。

研究人员回顾了来自食管远端/食管胃交界处的444例连续活检,以确定PAM的存在,并与一些临床和病理结果相关联。

研究显示,71(16%)出现胰腺腺泡化生。胰腺腺泡化生与患者年龄小于51(P < .001)、慢性心脏病(P = .01)和慢性质子泵抑制剂使用显著相关(P = .008)。令人惊讶的是,研究人员还发现PAM与慢性非甾体抗炎药物使用之间存在显著的相关性(P < .001)。这些关联,包括慢性非甾体抗炎药物的使用,在多变量分析中仍然显著。

本研究结果证实了先前关于PAM与慢性心脏病之间存在显著关联的报道,以及动物实验中关于使用慢性质子泵抑制剂的研究结果。但与慢性非甾体类抗炎药物的使用密切相关的研究尚未见报道,仍需要进一步的研究。

原始出处:

Suhair Al Salihi, MD; Vanya Jaitly, MD;Pancreatic Acinar Metaplasia in Distal Esophageal Biopsies Is Associated With Chronic Nonsteroidal Anti-inflammatory Drug Use

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    2020-04-17 yb6560
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    2019-05-11 zhouqu_8
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患者王某,男性,43岁。咽部异物感、咽部不适、疼痛多年,伴有口水多,有时咳嗽。加重1个月来诊。既往曾在耳鼻喉科和呼吸科多次就诊,诊断为慢性咽炎、气管炎、扁桃腺炎、咽后壁淋巴滤泡增生、鼻窦炎等。经过相应治疗,效果欠佳,症状反反复复,患者非常苦恼。

食管十二指肠空肠多发憩室病一例

患者,女性,84岁,主因食欲不振、上腹部胀满不适、偶有恶心反酸就诊,临床初诊为胃炎。来我科做上消化道钡餐检查,造影显示:食管吞钡后分别行正位及双斜位动态摄片,其中段可见2处钡剂存留,小者呈尖顶状突起,大者呈囊袋状下垂(图1、2、3)。大者约为32.5px×35px,卧位可见部分钡剂返流至食管。胃呈钩型,张力、蠕动均可,胃壁黏膜增粗。十二指肠球部充盈良好,其水平段可见1个突向肠腔外囊袋状影(图4)。

颈椎前路术后并发食管念珠菌病1例

患者,男,48岁,因“高处坠落致颈部疼痛、四肢无力1h”于2017年1月1日入院。

27厘米钢筷滑进患者食道,医生买筷子多次模拟手术后终取出

连云港一市民为催吐,用筷子刺激喉咙,不慎将20多厘米长的不锈钢长筷滑入食道,无奈紧急就医。钢筷又重又滑,接诊医生首次取筷失败。医护人员随后到超市购买同样的钢筷,多次模拟手术,最终用胃镜将这一异物取出。据医护人员了解,7月21日午饭后,连云港市市民张女士感觉胃部不适,想用筷子刺激喉咙以催吐,不慎将不锈钢筷子滑进食道。当天15时左右,她在家人陪同下,到连云港市第二人民医院就医求助。该院耳鼻喉科副主任

ICM:食管扩张-压迫气管-急性呼吸衰竭一例

44岁,女性,既往哮喘病史。因为喘鸣,对支气管扩张剂及激素无反应,立即进行气管插管。

一个差点漏诊的食管上段早癌病例,一起学习下

胃镜结合活检是发现上段癌的首选方法,但食管上段癌因解剖结构、病变部位、检查原因等因素,加之早期食管癌症状不典型,极易出现漏诊。