幽门螺杆菌感染与反流性食管炎关系的初步研究

The preliminary study on the Helicobacteria pylori and reflux esophagitis

目的 探讨幽门螺杆菌与反流性食管炎的关系。方法 选取７８例反流性食管炎患者，胃镜检查时取活检行快尿素酶检测幽门螺杆菌，病理检查证实慢性萎缩性胃炎及萎缩程度，住院患者同时行血清抗的门螺杆菌抗体检测，对照组为７８例无反流性食管炎的同期就诊患者。结果７８例反流性食管炎组幽门螺杆菌阳性者２４例（３１％），对照组幽门螺杆菌阳性者为５４例（６８％），统计学比较二者有显著性差异（Ｐ＜０．０１）。反流性食管炎组的慢性萎缩性胃炎发生率及萎缩程度均低于对照组。结论 反流性食管炎的幽门螺杆菌的感染率及慢性萎缩性胃炎的发生率较低，胃粘膜的萎缩程度较轻。胃幽门螺杆菌可通过引起慢性萎缩性胃炎使胃酸分泌减少，同时使胃酸中和物质增加，间接抑制了反流性食管炎的发生。因此对胃幽门螺杆菌阳性的反流性食管炎患者行幽门螺杆菌清除要慎重，以避免反流性食管炎的加重。

Objective To study the relationship between the Helicobacteria pylon infection and reflux esophagitis. Methos A total of 78 patients with reflux esophagitis were selected and compared with 78 control subjects. Diagnosis of H.pylori infection was made by rapid urease test or setum IgG antibodies. Seventy of atrophic gastritis was assessed by pathology. Results Helicobacteria pylori infection was found in 24(31%) patients with reflux esophagitis; whereas it was found in 54 (68%)control subjects. The incidence and the grade of atrophic gastritis were significantly lower in the reflux esophagitis than in control subjects. Conclusion The helicobacteria pylori infection in patients with reflux esophagitis was signilicantly lower and the atrophic gastritis was significantly milder than that in patients without it. It is possible that H.pylori infec- tion may be an inhibitory factor of reflux esophagitis through inducing atrophic gastrihs and concomitant hypoacidity.