幽门螺杆菌感染在非甾体抗炎药相关性胃病中作用的临床观察

Clinic Observation on Effects of Helicobacter Pylori-infection on Nonsteroidal Anti-inflammatory Drugs Associated Gastritic Damage

目的:对幽门螺杆菌感染在非甾体抗炎药(NSAIDs)相关性胃病中作用的临床观察.方法:选择连续服用NSAIDs治疗4～12周病人190例(服用药物主要为阿司匹林、双氯氛酸等),进行胃镜检查和病理组织学检查及胃黏膜炎症分级.将病人分为Hp感染组与Hp阴性组,分析两组的病理组织学改变的特点,了解是否有显著性差异.结果:(1)胃镜检查:轻度糜烂106例(55.8%,106/190).中-重度糜烂84例(44.2%,84/190).糜烂性胃炎的轻重程度与服药的剂量时间无明显的相关性.两组相比,有显著性差异(P<0.01).结论:服用NSAIDs 4周以上对胃黏膜有不同程度的损伤,如合并Hp感染的患者的胃黏膜损伤的严重程度远远高于非感染组.NSAIDs相关性胃病合并Hp感染须根除Hp.

Objective： To evaluate clinic observation on effects of helicobacter pylori infection on NSAIDs related gastric mucosal damage.Methods： The trial material included 190 patients who take NSAIDs for 4- 12 weeks continuously. They were examined by gastroscopy, histopathology and detected Hp. 190 patients were divided into Hp - positive and Hp - negative groups. To analyse the different features between two groups.Results： 46 patients （24.2%） were Hp- positive, Hp- negative group included 144 （75.8%）. On gastroscopy examination, 106 patients （55.8%） were mild mucosal erosive gastritis; 84 patients （44.2%） were middie - severe mucosal erosive injury. The degrees of erosive gastritis didn＇t associate with the dose of NSAIDs. There were not significantly difference between H. pylori positive group and non - H. pylori group （P 〉 0.05）. On histopathology examination, the degree of inflammation in H. pylori positive group is more severe than non - H. pylori group （ P 〈 0.01）. Conclusion： Our findings show that there will be mucosal damage to use NSAIDs for 4 weeks continuously. H.pylori infection and NSAIDs are independent risk factor for gastric mucosal injury. We suggest that it＇s necessary to eradicate H. pylori for the NSAIDs related gastric mucosal damage.