gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1330Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESПрогноз развития эрозий при наличии желудочной метаплазии слизистой оболочки пищевода у пациентов с гастроэзофагельной рефлюксной болезньюPrognosis of erosions development at gastric metaplasia of esophageal mucosa in patients with gastroesophageal reflux diseaseМастыковаЕ. К.MastykovaYe. K.КоноревМ. Р.KonorevM. R.МатвеенкоМ. Е.MatveyenkoM. E.Витебский государственный медицинский университетРоссияVitebsk State medical universityRussian Federation201201112012226913Copyright © Мастыкова Е.К., Конорев М.Р., Матвеенко М.Е., 20122012Мастыкова Е.К., Конорев М.Р., Матвеенко М.Е.Mastykova Y.K., Konorev M.R., Matveyenko M.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1330

Цель исследования. Определить прогностическое значение диагностики желудочной метаплазии слизистой оболочки пищевода в формировании эрозий у пациентов с гастроэзофагеальной рефлюксной болезнью (ГЭРБ).Материал и методы. В проспективное сравнительное исследование было включено 100 пациентов с ГЭРБ: мужчин – 57 (57%), женщин – 43 (43%), средний возраст 50,2±18,1 года. Длительность наблюдения составила от 3 до 10 лет. Пациентам выполнена эзофагогастродуоденоскопия с прицельной биопсией слизистой оболочки нижней трети пищевода. Анализ частоты появления эрозий проводили с заполнением таблицы 2×2 (для обработки использовался критерий χ2).Результаты. Установлена высокая диагностическая значимость наличия желудочной метаплазии слизистой пищевода для прогноза появления эрозий у пациентов с ГЭРБ: чувствительность – 80,7% (95% ДИ: 69,8–91,6%);специфичность – 83,3% (95% ДИ: 72,6–94,0%); доля правильных прогнозов – 82% (95% ДИ: 74,4–89,6%); относительный риск прогнозируемого исхода – 4,2; относительный риск иного исхода – 0,2 (95% ДИ: 0,1–0,39%); отношение шансов – 4,5 (95% ДИ: 1,6–12,7%).Выводы. Впервые установлена достоверная (p<0,001) ценность диагностики желудочной метаплазии у пациентов с ГЭРБ для прогноза развития эрозий слизистой оболочки пищевода в течение 3–10 лет.

Aim of investigation

Aim of investigation. To determine prognostic value of diagnostics of gastric metaplasia of esophageal mucosa in development of erosions in patients with gastroesophageal reflux disease (GERD).

Material and methods

Material and methods. Overall 100 patients with GERD have been enrolled in prospective comparative study: men – 57 (57%), women – 43 (43%), mean age was 50,2±18,1 years. Duration of follow-up was 3 to 10 years. Patients underwent esophagogastroduodenoscopy with guided biopsy of mucosa of the lower third of esophagus. Analysis of erosions frequency was carried out by 2 by 2 table (for χ2 criterion analysis).

Results

Results. The high diagnostic value of presence of gastric metaplasia of esophageal mucosa for prognosis of erosions in patients with GERD was revealed: sensitivity – was 80,7% (95% CI: 69,8–91,6%); specificity – 83,3% (95% CI: 72,6–94,0%); rate of correct prognoses – 82% (95% CI: 74,4–89,6%); relative risk of prognosticated outcome – 4,2; relative risk of different outcome – 0,2 (95% CI: 0,1–0,39%); odds ratio – 4,5 (95% CI: 1,6–12,7%).

Conclusions

Conclusions. For the first time significant value of gastric metaplasia diagnostics in patients with GERD (p<0,001) for the prognosis of erosions of mucosa of the esophagus within 3–10 years it was found.

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The authors declare that there are no conflicts of interest present.