幽门螺杆菌感染与军人胆汁反流性胃炎伴消化性溃疡的相关性研究

Relationship between helicobacter pylori infection and bile reflux gastritis complicated with peptic ulcer among servicemen

目的探讨军人胆汁反流性胃炎或伴消化性溃疡(PU)与幽门螺杆菌(HP)感染和病理的关系。方法收集我院2008年1月—2013年12月收治的南方某部队军人胆汁反流性胃炎患者136例,其中,单纯胆汁反流性胃炎72例(胆汁反流性胃炎组),胆汁反流性胃炎伴PU 64例(胆汁反流性胃炎伴溃疡组),取同期收治的60例单纯PU为随机对照(PU对照组)。所有患者均行内镜和组织活检,碳-13呼气快速尿素酶试验和组化染色法检测HP感染,组织学分析胃黏膜的病理变化。结果 136例胆汁反流性胃炎患者中PU发生率为47.1%(64/136),HP感染率为44.9%(61/136),胆汁反流性胃炎组、胆汁反流性胃炎伴溃疡组和PU对照组HP感染率分别为31.9%(23/72)、59.4%(38/64)和71.7%(46/60);胆汁反流性胃炎组与后两组HP感染率比较,有统计学差异(P<0.01),而后两组比较无统计学差异(P>0.05)。胆汁反流性胃炎伴溃疡组的腺体萎缩、肠上皮化生、不典型增生检出率均明显高于胆汁反流性胃炎组和PU对照组(P<0.05);胆汁反流性胃炎组与PU对照组比较,腺体萎缩、肠上皮化生、不典型增生检出率无统计学差异(P>0.05);三组间活动性炎症检出率均无统计学差异(P>0.05)。结论胆汁反流和HP感染与军人胆汁反流性胃炎伴PU的发病和进展有关。

Objective To discuss the relationship between bile reflux gastritis（ BRG） with / without peptic ulcer（ PU） and helicobacter pylori（ HP） infection and pathological change in military. Methods A total of 136 BRG patients from some southern army admitted to our hospital from January 2008 to December 2013 were enrolled in the study. There were 72 patients with BRG alone（ BRG group） and 64 ones with BRG and PU（ BRG ＋ PU group）. Another 60 patients with PU alone were enrolled as controls（ PU control group）. All the patients underwent gastroscopy and biopsy. The existence of HP infection was detected with carbon-13 urea breath test and staining,and then the pathological changes in gastric mucosa were analyzed. Results The incidence rate of BRG plus PU was 47. 1%（ 64 /136） and the Hp infection rate was 44. 9%（ 61 /136）. The HP infective rates were 31. 94%（ 23 /72）in the BRG group,59. 4%（ 38 /64） in the BRG ＋ PU group and 71. 7%（ 46 /60） in the PU control group,respectively. There was significant difference between the BRG group and the BRG ＋ PU group（ P〈0. 05）,and no significant difference was found between the BRG ＋ PU group and the PU control group（ P〈0. 05）. The incidences of glandular epithelial atrophy,intestinal metaplasia and atypical hyperplasia of the BRG ＋ PU group were significantly higher than that of any of the other groups（ P〉0. 05）.The incidence of active gastric mucosa inflammation was of no significant difference among the three groups（ P〈0. 05）. Conclusion Bile reflux and HP infection may be associated with the occurrence and the development of BRG with PU in the servicemen.