À§ºÐ¹®ºÎ Àå»óÇÇÈ»ýÀº À§½Äµµ¿ª·ùÁúȯ ȤÀº Helicobacter pylori °¨¿°°ú ¿¬°üÀÌ Àִ°¡?
Is Intestinal Metaplasia of the Gastric Cardia associated with Gastroesophageal Reflux Disease or Helicobacter pylori Infection?
¼Ò¼Ó »ó¼¼Á¤º¸
Àü¼º±¹/Sung Gook Jeon
ÀüÀÌ°æ/¹Ú±âÈ£/ȲÀϼø/±èÀºÁÖ/Yee Gyung Jeon/Gee Ho Park/Il Soon Hwang/Eun Joo Kim
KMID : 0614620000360060721
Abstract
¸ñÀû: À§ºÐ¹®ºÎ¿¡ ¹ß»ýÇÏ´Â ¿°ÁõÀ̳ª Àå»óÇÇÈ»ýÀÌ À§½Äµµ¿ª·ùÁúȯ¿¡ ÀÇÇÑ °ÍÀÎÁö ȤÀº H. pylori
°¨¿°¿¡ ÀÇÇÑ °ÍÀÎÁö¿¡ ´ëÇؼ´Â ³í¶õÀÌ ÀÖ´Ù. ÀÌ ¿¬
±¸ÀÇ ¸ñÀûÀº À§ºÐ¹®ºÎÀÇ Àå»óÇÇÈ»ý ¹ß»ý¿¡ ÀÖ¾î¼
À§½Äµµ¿ª·ù¿Í H. pylori °¨¿°ÀÇ ¿ªÇÒÀ» ¾Ë¾Æº¸°íÀÚ
ÇÏ¿´´Ù. ´ë»ó ¹× ¹æ¹ý :¿ª·ù¼º ½Äµµ¿°ÀÌ ÀÖ´Â 37 ¸í
(³² :³à =12:25,Æò±Õ ¿¬·É : 48.0 ¼¼ )À» ȯÀÚ±ºÀ¸·Î ÇÏ
°í, °Ç°°ËÁøÀ» À§ÇØ ³»¿øÇÏ°í ¼ÒȱâÁõ»óÀÌ ¾ø´Â
¼öÁøÀÚ Áß È¯ÀÚ±º°ú ¿¬·É ¹× ¼ºº°À» ¸ÂÃß¾î 30 ¸í
(³² :³à =10:20,Æò±Õ ¿¬·É : 48.3 ¼¼ )À» ´ëÁ¶±ºÀ¸·Î ÇÏ
¿© ÀüÇâÀûÀ¸·Î ¿¬±¸ÇÏ¿´´Ù .¾ç±º ¸ðµÎ À§³ª ½Äµµ ¼ö
¼ú·Â, À§³»½Ã°æ 30 ÀÏ Àü±îÁö À§»êºÐºñ¾ïÁ¦Á¦³ª Ç×»ý
Á¦ º¹¿ë·Â, ¼Òȼº ±Ë¾çÀ̳ª À§¾ÏÀÌ ÀÖ´Â °æ¿ì ±×¸®
°í °ú°Å¿¡ H. pylori Ä¡·á·ÂÀÌ ÀÖ´Â °æ¿ì´Â Á¦¿ÜÇÏ¿´
´Ù. À§ÀüÁ¤ºÎ, üºÎ, ÀúºÎ ±×¸®°í À§½Äµµ Á¢ÇպΠÁ÷
ÇϹ濡¼ °¢°¢ 2 °³¾¿ Á¶Á÷»ý°ËÀ» ½ÃÇàÇÏ¿´´Ù .¸ðµç
»ý°Ë Á¶Á÷Àº H&E ¿°»ö, Giemsa ¿°»ö ±×¸®°í Alcian
blue (pH 2.5)¿°»öÀ» ÇÏ¿´°í, À§¿°ÀÇ Á¤µµ´Â updated
Sydney system ¿¡ µû¶ó Á¶»çÇÏ¿´´Ù. °á°ú : H. pylori
°¨¿° À¯º´·üÀº ȯÀÚ±º (56.8%, 21/37)°ú ´ëÁ¶±º
(56.7%, 17/30)»çÀÌ¿¡ À¯ÀÇÇÑ Â÷ÀÌ°¡ ¾ø¾ú´Ù. ºÐ¹®
ºÎ ¿°ÁõÀº ´ë»óÀÚ ´ëºÎºÐ (97%)ÀÌ ÀÖ¾ú°í, ´ëÁ¶±ºÀÌ
ȯÀÚ±º¿¡ ºñÇØ ºÐ¹®ºÎ ¿°ÁõÀÌ ½ÉÇß´Ù. ±×¸®°í ¾ç±º
¸ðµÎ ºÐ¹®ºÎ ¿°ÁõÀÇ Á¤µµ¿Í H. pylori °¨¿°°ú´Â À¯ÀÇ
ÇÑ »ó°ü°ü°è°¡ ÀÖ¾ú´Ù (p<0.05).ºÐ¹®ºÎ Àå»óÇÇÈ»ý
ÀÇ À¯º´·üÀº ȯÀÚ±º (24.3%, 9/37)°ú ´ëÁ¶±º (46.7%,
14/30)»çÀÌ¿¡ À¯ÀÇÇÑ Â÷ÀÌ°¡ ¾ø¾úÁö¸¸, ¾ç±º ¸ðµÎ
Àå»óÇÇÈ»ýÀÌ ÀÖ´Â ´ë»óÀڵ鿡¼ H. pylori °¨¿° À¯
º´·üÀÌ ³ô¾Ò´Ù (p<0.05). °á·Ð :À§ºÐ¹®ºÎÀÇ Àå»óÇÇÈ
»ýÀº À§½Äµµ¿ª·ùÁúȯº¸´Ù´Â H. pylori °¨¿°°ú ¿¬°ü
ÀÌ ÀÖÀ» °ÍÀ¸·Î »ý°¢µÈ´Ù.
Background/Aims: It is unknown whether cardia intestinal metaplasia (IM) is associated with gastroesophageal reflux disease (GERD) or Helicobacter pylori (H. pylori) infection. The aim of the present study was to investigate the role of GERD and
H.
pylori infection in the development of cardia IM. Methods: Thirty-seven consecutive patients with reflux esophagitis were studied. Thirty age-and sex-matched, asymptomatic subjects were studied as a control group. Two biopsy specimens were
obtained
from
antrum, body, fundus and cardia, respectively. All specimens were stained with H&E, Alcian-blue and Giemsa. The severity of gastritis was graded according to the updated Sydney system. Results: Carditis in controls was more severe than that in
patients
with reflux esophagitis. The prevalence of H. pylori infection was correlated with degree of carditis in each group (p<0.05). The prevalence of cardia IM was not significantly different between patients with reflux esophagitis (24.3%) and
controls
(46.7%). However, H. pylori infection was more common in subjects with cardia IM than in subjects without cardia IM in each group (p<0.05). Conclusions: Cardia IM may be associated with H. pylori infection, but not with GERD.
Å°¿öµå
Àå»óÇÇÈ»ý; ºÐ¹®ºÎ¿°; Helicobacter pylori; °¨¿°; À§½Äµµ¿ª·ùÁúȯ; Intestinal metaplasia; Carditis; Helicobacter pylori infection; Gastroesophageal reflux disease;
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