幽门螺杆菌感染与胃部疾病的相关性

Relationship of Helicobacter Pylori Infection and Gastric Disease

[目的]探讨幽门螺杆菌(Hp)感染在胃癌发生发展中的作用。[方法]选择2009年1月至2012年12月经胃镜检查病理确诊胃部疾病439例患者,其中慢性浅表性胃炎163例、慢性萎缩性胃炎64例、胃食管反流病47例、胃溃疡79例、十二指肠溃疡54例、胃不典型增生12例和胃癌20例。采用C14呼气实验和快速尿素酶法,二项任意一项阳性均被诊断胃Hp阳性。[结果]胃部疾病439例患者中Hp阳性219例,阳性率为49.89%。胃癌患者的Hp阳性率比慢性胃炎患者Hp阳性率高(65.00%vs 43.17%,χ2=3.850,P=0.043),也比胃食管反流病患者Hp阳性率高(65.00%vs 34.04%,χ2=5.477,P=0.019),但与胃、十二指肠溃疡患者比较Hp阳性率无统计学差异(65.00%vs 63.91%,χ2=0.009,P=0.925)。60岁以下者,随年龄增长Hp感染率逐渐升高。[结论]胃幽门螺杆菌感染与胃溃疡、不典型增生和胃癌的发生有着密切的关系,幽门螺杆菌感染是胃癌的危险因素。根除Hp感染治疗可能有助于降低胃癌发生的风险。

[Purposel To investigate the clinical value of Helicobacter pylori infection in patients with gastric diseases. [Methodsl A total of 439 cases of gastric disease pathologically proven form Jan, 2009 to Dec,2012 were analyzed,including 163 cases with chronic superficial gastritis,64 cases with chronic atrophy gastritis,47 cases with gastroesophageal reflux disease,79 cases with gastric ulcer,54 cases with duodenal ulcer, 12 cases with gastric atypical hyperplasia and 20 cases with gastric cancer. Helicobacter pylori infection was detected by （14）C-breath test and rapid urease. [Results] Of 439 cases with gastric disease,219 cases was Hp positive with Hp infection rate of 49.89%. The Hp infection rate in gasfrie cancer was higher than that in chronic gastritis （65.00% vs 43.17% ,χ^2=3.850,P=0.043）,and that in gastroesophageal reflux disease （65.00% vs 34.04% ,χ^2= 5.477,P=-0.019）, but was not significant difference with gastric -duodenal ulcer（65.00% vs 63.91%, χ^2=0.009,P=0.925）. Hp infection rate increased with age increasing in age less than 60 years old. [Conclusion ] Gastric Helieobacter pylori infection is closely related to duodenal ulcer, gastric atypical hyperplasia and gastric cancer. Helicobacter pylori is a high risk factor for gastric cancer. Helicobacter pylori eradication might reduce the risk for gastric cancer.