不同检测方法探讨幽门螺杆菌感染与Barrett食管之间的关系

The relationship between Helicobacter pylori infection and Barrett's esophagus by different detection methods

目的比较不同检测方法显示的幽门螺杆菌(Helicobacter pylori,H.pylori)感染状况与Barrett食管(Barrett’s esophagus,BE)之间的关系。方法随机收集确诊BE患者84例,同期收集无消化道症状的内镜检测阴性的正常体检者84例作为对照。采用快速尿素酶法、病理中性复红染色法及13C呼气法分别检测患者的幽门螺杆菌感染情况,并收集患者的临床病理资料进行统计学分析。结果快速尿素酶法或病理中性复红染色法检测H.pylori阳性的患者BE组食管下段黏膜阳性率为14.3%(12/84),胃窦部黏膜阳性率为45.2%(38/84),对照组食管下段黏膜及胃窦部黏膜H.pylori阳性率分别为16.7%(14/84)、61.9%(52/84);13C呼气试验检测H.pylori阳性的患者BE组为64.3%(54/84),对照组为66.7%(56/84)。快速尿素酶法或病理中性复红染色法检测食管下段黏膜H.pylori阳性率BE组与对照组比较无显著差异(P>0.05),胃窦黏膜H.pylori阳性率在两组间有显著差异(P<0.05);13C呼气法显示BE组与对照组H.pylori阳性率无显著差异(P>0.05)。结论快速尿素酶法及病理中性复红染色法显示胃窦部H.pylori感染对BE可能具有保护作用,而13C呼气试验显示H.pylori感染可能对BE不具有保护作用,两者的确切关系尚需要进行大样本、多因素的深入研究。

Objective To compare the relationship between Helicobacter pylori（H.pylori） infection and Barrett＇s esophagus by different detection methods.Methods Eighty-four patients diagnosed as Barrett＇s esophagus and 84 cases of non-gastro-esophageal reflux disease（non Barrett＇s esophagus patients as controls） were enrolled in this project.Rapid urease enzyme test（RUT）,neutral red staining and 13 breath test were used to detect H.pylori infection.Results The H.pylori positive rates were 14.3%（12/84） in esophageal mucosa and 45.2%（38/84） in gastric mucosa of all the Barrett＇s esophagus patients,and they were 16.7%（14/84）,61.9%（52/84） in the controls by RUT and pathological staining detection methods.The H.pylori positive rate was 64.3%（54/84） in the Barrett＇s esophagus patients,and it was 66.7%（56/84） in the controls by 13 carbon detection method.There was no significant difference（P0.05） of H.pylori positive rate in esophageal mucosa between BE and control groups and there was significantly different（P0.05） in gastric mucosa between the above two groups detecting by RUT and pathological staining.There was no significant difference（P0.05） of H.pylori positive rate between Barrett＇s esophagus and control group detecting by 13 carbon breath test.Conclusion The H.pylori infection in gastric mucosa may have a protective effect for the Barrett＇s esophagus patients detecting by RUT and pathological staining,but it may not have the same effect by the 13 carbon breath test detection.So,the exact relationship is need for a large sample,multi-factors study between the above two groups.