背景:胃无意义病通常会引起严重的腹部症状;然而,我们在食管胃十二指肠镜检查中偶然发现无症状的胃失联症病例。与胃anisakiasis引起的急性腹部症状相关的因素尚不清楚。因此,本研究旨在通过比较有症状和无症状的病例,探讨与腹部症状相关的临床因素。
方法:这是一项回顾性队列研究,涉及2015年10月至2021年10月在日本9家医院诊断为胃无囊病的264例患者。我们分析了患者的病历和内窥镜图像,并比较了有症状和无症状组之间的临床因素。
结果:一百六十五名患者(77.8%)被诊断为腹部症状,47例(22.2%)无症状。年纪大了,男性,糖尿病,胃粘膜萎缩,无症状组的Anisakis穿透区胃粘膜萎缩明显多于有症状组。多变量分析显示,年龄(p=0.007),性别(p=0.017),有无粘膜萎缩(p=0.033)是急性腹部症状发生的独立因素。此外,幽门螺杆菌初治的病例,随着白细胞的升高,有症状组比无症状组更常见或无嗜酸性粒细胞升高.
结论:年龄,性别,胃粘膜萎缩的存在与否是与急性腹部症状发生相关的临床因素。老年和男性患者以及胃粘膜萎缩的患者不太可能出现腹部症状。胃失踪症引起的症状的发生机制尚不清楚;然而,我们的结果将有助于澄清这个问题。
BACKGROUND: Gastric
anisakiasis typically causes severe abdominal symptoms; however, we incidentally detected asymptomatic gastric
anisakiasis cases during esophagogastroduodenoscopy. The factors associated with developing acute abdominal symptoms induced by gastric
anisakiasis remain unclear. Therefore, this study aimed to investigate the clinical factors associated with abdominal symptoms of gastric
anisakiasis by comparing symptomatic and asymptomatic cases.
METHODS: This was a retrospective cohort study involving 264 patients diagnosed with gastric anisakiasis at nine hospitals in Japan between October 2015 and October 2021. We analyzed patients\' medical records and endoscopic images and compared the clinical factors between the symptomatic and asymptomatic groups.
RESULTS: One hundred sixty-five patients (77.8%) were diagnosed with abdominal symptoms, whereas 47 (22.2%) were asymptomatic. Older age, male sex, diabetes mellitus, gastric mucosal atrophy, and gastric mucosal atrophy of the Anisakis penetrating area were significantly more common in the asymptomatic group than in the symptomatic group. Multivariate analysis revealed that age (p = 0.007), sex (p = 0.017), and presence or absence of mucosal atrophy (p = 0.033) were independent factors for the occurrence of acute abdominal symptoms. In addition, cases that were Helicobacter pylori naïve, with an elevation of white blood cells, or without an elevation of eosinophils were more common in the symptomatic group than in the asymptomatic group.
CONCLUSIONS: Age, sex, and presence or absence of gastric mucosal atrophy were the clinical factors associated with the occurrence of acute abdominal symptoms. Older and male patients and those with gastric mucosal atrophy were less likely to show abdominal symptoms. The mechanisms of the occurrence of symptoms induced by gastric
anisakiasis remain unclear; however, our results will help clarify this issue in the future.