骨性关节炎患者胃肠损害与幽门螺旋杆菌感染的相关性研究

Roles of Helicobacter Pyiori Infection in the Induction of Gastrointestinallesions of OA Patients

目的:探讨Hp在骨性关节炎(OA)患者胃肠损害中可能发挥的作用。方法:以12例特发性消化性溃疡(PUD)患者为对照,对36例OA患者进行胃镜检查,同时应用免疫印迹法测定患者血清抗Hp抗体水平,行^(14)C呼气试验(^(14)C-UBT),综合判定Hp感染状态。统计OA患者Hp感染与胃镜下改变及临床指标的相关性。结果:OA组的Hp感染率明显低于PUB组(P<0.05),OA组中,Hp感染者发生消化道溃疡的比例明显高于无Hp感染者(分别为18.25%和7%,P<0.05)。OA患者发生溃疡的主要危险因素为长期不间断服用NSAIDs(>半年)、(RR=16.02,P<0.05)、年龄>60岁(RR=10.42,P<0.01)及Hp感染(RR=5.81,P<0.05),尤其以上三种因素同时存在时,发生消化道溃疡的危险性显著增高(RB=34.1,P<0.001)。结论:Hp感染参与了OA患者胃肠溃疡的发生,Hp可能与NSAIDs一道,具有协同致消化道溃疡作用。

Objective：To explore the possible role of Helieobacter pylori（ Hp ） in the induction of gastroduodenal tract, s lesions of ostarthritis（OA） patients. Methods： After gastric endoscopy was performed on the patients with 36 OA. 12 peptic ulcer disease（ PUD）, Hp infection was synthetically identified by serologic anti -Hp antibody test （ELISA） and ^14C -urea Breath Test （^14C -UBT）. Association of Hp infection with endoscopic and clinical findings was analyzed. Results： The rate of infection by Hp in OA patients significantly lower than that in patients with PUB（ P 〈0. 05 ）. In OA group,the prevalence of peptic ulcer was significantly higher in Hp positive patients than that in lip negative ones（ 18.25%and 7%,P 〈0. 05）. The main risk factors that predispose OA patients to the development of peptic ulcer included the persistent use of NSAIDs（ 〉half year） ,（ RR = 16. 02, P 〈0. 05 ） ,the age of more than 60（ RR = 10. 42, P 〈 0. 01 ）and Hp infection （RR = 5.81 ,P 〈 0. 05 ）. When three above - mentioned risk factors coexisted, the risk would be increased subsequently （ RR = 34. 1, P 〈 0. 001 ）. Conclusion： The infection by Hp may be involved in the development of gastroduodenal tract, s lesions in OA patients. Hp along with NSAIDS may play a synergie roly in the induction of gastroduodenal tract ,s lesions of OA patients.