在台灣關於菸酒及檳榔對上消化道疾病的影響

Effects of alcohol consumption, cigarette smoking, betel quid chewing in upper digestive disease in Taiwan

吳孟杰(Meng-Chieh Wu)

指導教授 ： 吳明蒼

高雄醫學大學/健康科學院/公共衛生學系職業安全衛生碩士班/碩士(2017年)

摘要

背景:在世界上，已知菸、酒和檳榔是常見的生活行為。我們的研究在於評估這三項物質和上消化道疾病的關聯性。
方法: 從2008年4月至2013年12月期間，我們在高雄及屏東地區四家不同的醫學中心及區域醫院一共收集了九千二百七十五位大於20歲的且接受內視鏡檢查及問券的病患。我們使用了多項式迴歸分析方式分析各項不同的危險因子和包含食道、胃、十二指腸的不同疾病的關係。
結果:在9275位病人中，2991位病人(32.25%)有洛杉磯分級A-B逆流性食道炎，416位病人(4.49%)有巴雷特氏食道。51人(0.55%)被診斷出食道癌和56人(0.6%)被診斷出胃腺癌。1054位病患(11.36%)被診斷為胃潰瘍和1687位病人(18.19%)被診斷為十二指腸潰瘍
合併同時有抽菸、喝酒、嚼檳榔的病人在洛杉磯分級A-B逆流性食道炎有1.59倍的風險(95% CI=1.50-2.59)，罹患食道癌方面有16.32倍的風險(95% CI=7.13-37.36)，在巴雷特氏食道有2.93倍的風險(95% CI=1.99-4.30)，胃潰瘍方面有1.97倍風險(95% CI=1.50-2.59)和十二指腸潰瘍方面有1.27倍的風險(95% CI=1.00-2.69)。
結論:抽菸、喝酒和嚼檳榔是上消化道疾病的危險因子並且會有協同效應。

關鍵字

抽菸 ； 喝酒 ； 嚼檳榔 ； 上消化道

並列摘要

Background: Cigarette smoking, alcohol drinking, and betel quid chewing are common habitual behaviors in the world. In our study, we want to identify the association between use of these three substances and upper digestive diseases.

Method: There were 9,275 patients (>20 years-old) in this study between April 2008 and December 2013 in Kaohsiung and Pingtung. They received esophagogastroduodenoscopy and was interviewed by interviews using a standardized questionnaire. Polynomial regressions were used to analyze the association between risk factors and different diseases in esophagus, stomach and duodenum.

Results: In 9,275 patients, 2,991 patients (32.25%) had grade A-B erosive esophagitis , , 416 patients(4.49%) had Barrett’s esophagus. 51 subjects(0.55%) were diagnosed with esophageal cancer and 56 patients(0.6%) had gastric adenocarcinoma .1,054 patients(11.36%) were diagnosed with gastric ulcer and 1,687 patients(18.19%) diagnosed with duodenal ulcer.
Patients who used cigarettes, alcohol and betel areca had 1.59-fold risk of grade A-B erosive esophagitis (95% CI = 1.27-1.98), 16.32-fold risk of esophageal cancer (95% CI =7.13-37.36), 2.93-fold risk of Barrette’s esophagus (95% CI =1.99-4.30), 1.97-fold risk of gastric ulcer (95% CI =1.50-2.59), and 1.27-fold risk of duodenal ulcer (95% CI =1.00-2.69). Conclusions: In our study, cigarette smoking, alcohol drinking and betel quid chewing were risk factors and had synergistic effects for upper digestive tract diseases.

並列關鍵字

smoking ； alcohol ； betel quid ； upper digestive

參考文獻

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