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目的探讨食管癌高发区肥城市食管炎的影响因素。方法在肥城市一食管癌高发乡镇40~69岁队列人群中,采用染色内镜和活检病理诊断方法确诊食管炎357例,作为病例组,另选取内镜检查食管黏膜正常者500例作为对照组。分析食管癌家族史、吸烟、饮酒、营养成分等与食管炎的关联,以OR及95%CI作为评价关联强度的指标。结果将性别、年龄作为调整因素,以无食管癌家族史为比较的基线水平(OR=1.0),一级亲属患食管癌的OR为1.830(95%CI:1.183~2.833);以吸烟指数=0为比较的基线水平,吸烟指数≥500的OR为1.852(95%CI:1.142~3.005);以饮酒指数=0为比较的基线水平,饮酒指数<130和≥130的OR分别为1.789(95%CI:1.141~2.804)、1.642(95%CI:1.029~2.621);将吸烟(吸烟、不吸烟)、饮酒(饮酒、不饮酒)情况进行组合,以不吸烟+不饮酒为比较的基线水平,吸烟+饮酒的OR为1.889(95%CI:1.143~3.122);将各营养成分年摄入量划分为3个层次,以最低水平为比较的基线水平,发现脂肪、叶酸、铁的影响达到显著性水平(OR均小于1)。结论食管癌家族史、吸烟、饮酒是食管炎的危险因素,营养成分对食管炎的影响不明显。在食管癌高发区,特别是在有食管癌家族史的人群中,提倡戒烟戒酒,对预防食管炎进而减少食管增生和食管癌的发生具有重要的作用。
Objective To explore the influencing factors of esophagitis in Feicheng City in the high risk area of esophageal cancer. Methods 357 cases of esophagitis were diagnosed by staining endoscopy and biopsy pathology in the cohort of 40-69 years old with high incidence of esophageal cancer in Feicheng City and 500 cases with normal esophageal mucosal endoscopy as the control group . Analysis of family history of esophageal cancer, smoking, alcohol consumption, nutritional components and esophagitis associated with OR and 95% CI as an indicator of correlation strength. Results The odds ratio (OR = 1.0) for first-degree relatives with esophageal cancer was 1.830 (95% CI: 1.183-2.833). The smoking index was OR of 1.852 (95% CI: 1.142-3.005) with smoking index ≥ 500 and OR of <130 and ≥ 130 with drinking alcohol index of 0 were 1.789 (95 % CI: 1.141 ~ 2.804), 1.642 (95% CI: 1.029 ~ 2.621). The baseline level of smoking (smoking and non-smoking) and drinking (drinking and not drinking) were compared with those of non-smoking and non-drinking (95% CI: 1.143-3.122). The annual intake of various nutritional components was divided into three levels, with the lowest level as the baseline level of comparison, and the effect of fat, folic acid and iron was reached Significance levels (OR less than 1). Conclusion Family history of esophageal cancer, smoking and drinking are the risk factors of esophagitis. The effect of nutrition on esophagitis is not obvious. In esophageal cancer-prone areas, especially in people with a family history of esophageal cancer, to promote smoking cessation and alcohol abstinence, to prevent esophagitis and thus reduce the incidence of esophageal proliferation and esophageal cancer has an important role.