幽门螺杆菌感染与胃食管反流病的相关性

Investigation of relationship between helicobacter pylori infection and gastroesophageal reflux disease

目的探讨幽门螺杆菌(helicobacter pylori,H.pylori)与胃食管反流病(gastroesophageal reflux disease,GERD)的关系。方法配对研究通过胃镜和病理诊断为GERD与单纯慢性胃炎(chronic gastritis,CG)患者间的H.pylori感染,并探讨H.pylori感染与GERD的胃镜及病理分级间的关系。结果共152对GERD患者中Hp(-)111例(73.0%),Hp(+)41例(27.0%);CG患者中Hp(-)91例(59.9%),Hp(+)61例(40.1%),GERD患者中Hp(+)者比CG患者中少见(P<0.05)。胃镜下Ⅰ、Ⅱ、Ⅲ级GERD在Hp(+)中分别占61.0%、12.2%、26.8%;Hp(-)中分别占57.6%、7.2%、35.1%;病理分级轻、中、重度GERD在Hp(+)中分别占70.7%、14.6%、14.6%,Hp(-)中分别是61.3%、22.5%、16.2%;Hp(+)患者以轻度炎症多见、重度炎症少见。结论GERD可能对H.pylori的生存有抑制作用,GERD多发生于H.pylori阴性患者;H.pylori阳性患者中GERD的炎症程度较轻。

Objective To investigate the relationship between helicobacter pylori （H. pylori）infection and gastroesophageal reflux disease（GERD）. Methods H. pylori infection rates of GERD in patients with simple chronic gastritis（CG）, which was confirmed by endoscope combined with pathological diagnosis were researched. The relationship between H. pylori infection and GERD classifications using endoscope and pathology was explored. Results H. pylori infection was found 41 （27. 0% ） in 152 cases of GERD and 61 （40. 1% ） in 152 cases in simple CG patients respectively,H, pylori infection positive in GERD patients is less than it of simple CG patients. GERD of class Ⅰ , Ⅱ and Ⅲ using endoscope were 61.0%, 12. 2% and 26. 8% in H. pylori positive cases respectively,while they were 57.6% ,7.2% and 35.1% respectively in H. pylori negative ones. However, mild, moderate and severe GERD identified by pathohistology were 70.7%, 14. 6% and 14. 6% in H. pylori positive cases respectively, and they were 61.3% ,2.5% and 16.2% respectively in H. pylori negative ones. Conclusion All above results suggested that H. pylori possibly has prevention role in some extent to pathogenesis of GERD. GERD was seen in H. pylori negative cases more commonly. GERD could inhibit the H. pylori surviving. So GERD was occurred frequently in H. pylori negative patients. The inflammatory extent of GERD is not serious in H. pylori positive patients.