幽门螺杆菌与胃食管反流病的关系

The Relation between Helicobacter Pylori and Gastroesophageal Reflux Disease

目的本文研究了Hp阴性和Hp阳性的胃食管反流病(GERD)患者食管动力学和食管酸暴露情况,以阐明Hp感染和GERD两者之间的关系。方法纳入GERD患者64例,按Hp感染情况分为Hp阳性组37例,Hp阴性组27例。检测前1周停用抑酸药和胃肠动力药。对2组进行食管动力学检测和食管24 h pH监测。结果①Hp阳性和Hp阴性组性别、年龄和体质量指数无显著性差异(P>0.05)。②Hp阳性和Hp阴性组食管动力学检测:LES压力、长度及食管体部的各项动力学指标均无显著差异(P>0.05)。③Hp阳性和Hp阴性组24 h食管pH监测DeMeester评分、食管pH<4时间百分比、pH<4反流次数、pH<4大于5min反流次数、pH<4最长反流持续时间均无显著性差异(P>0.05)。④本研究中GERD患者食管下端括约肌压力(LESP)为(9.1±1.9)mm Hg,明显低于正常人,但它和DeMeester评分无相关性(r=0.130,P=0.304)。结论①Hp感染对胃食管反流病患者的LESP和食管体部的运动功能无明显影响;②Hp感染对胃食管反流病患者的食管酸暴露也没有显著影响;③Hp感染与胃食管反流病的发生没有明显关系。

Objective To compare esophaguseal motor functions and esophaguseal acid exposure in Hp positive GERD and Hp negative GERD. in order to elucidate the relation between Hp and GERD,and to provide reference for clinical management of GERD. Methods Sixty-four patients diagnosed GERD were divided into two groups： Hp positive （n=37）and negative （n=27） groups. Antacids and prokinetic agents had been discontinued for 7 days prior to the study. Esophageal manometry and 24 hour pH monitoring were performed. Results （1）There were no significant differences in gender,age and body index in Hp positive and negative groups（P〉0.05）. （2）There were no significant differences in lower esophageal sphincter （LES） pressure and longitude between Hp positive and negative groups, so do in the esophageal body motor functions（P〉0.05）. （3）The DeMeester score, the total percent of reflux time, the total number of reflux episodes, the number of reflux episodes lasting for more than 5 min and the duration of longest reflux episode had no significant difference between Hp positive and negative groups （P〉0.05）. （4）The lower esophageal-spldncter （LES） pressure[ （9.1±1.9） mm Hg], were [ower than that in normal persons,but have no correlation with DeMeester score（r=0. 130,P=0. 304）. Conclusion （1）Hp infection may have no effect on LES and esophaguseal body motor functions in GERD;（2）Hp infection may have no effect on acid exposure in GERD;（3）There is no obviously relationship between Hp infection and the occurrence of GERD.