应激状态下幽门螺杆菌感染与胃黏膜损伤的关系探讨

Study of the relationship between the stress injury of gastric mucosa and Helicobacter pylori infection

目的研究应激时胃黏膜的损伤程度与幽门螺杆菌(Hp)感染的变化情况及其相关性。方法选取新兵60名,在其军训前后进行血清皮质醇(COR)、儿茶酚胺(CA)、14 C-尿素呼气试验、Hp抗体检测,以及《症状自评量表》(SCL-90)评估,部分受试者行胃镜检查和胃黏膜病理分析。结果心理调查问卷分析中,军训后较军训前SCL-90总分、躯体化、抑郁、偏执分明显升高,与军训前比较,差异有统计学意义(P<0.05)。军训后新兵的血清COR和CA水平分别为(276.64±156.89)μg/dL、(320.76±123.75)pg/mL,明显高于军训前的(8.28±2.43)μg/dL、(18.69±5.98)pg/mL,差异有统计学意义(P<0.05)。胃黏膜病理检查显示军训后胃黏膜炎症积分和14 C-尿素呼气试验检测结果明显升高。结论应激可导致胃黏膜损伤加重,且加重了机体Hp的感染。

Objective To study the correlation of gastric mucosa injury degree and Helicobacter pylori（Hp）infection of new recruited soldiers before and after military training.Methods Sixty new recruited soldiers participated in this study.The Symptom Checklist（SCL-90）,the test of serum cortisol（COR）,catecholamine（CA）,anti-Hp antibodies and 14 C-urea breath were carried before and after training respectively.Some subjects received gastroscopy and gastric mucosa pathological analysis.Results The SCL-90 total score,somatization,depression,paranoia score after training were significant higher than scores before training（P〈0.05）.At the same time,the levels of serum COR and CA after training were（276.64±156.89）μg/dL,（320.76±123.75）pg/mL,which were significant higher than（8.28±2.43）μg/dL,（18.69±5.98）pg/mL before training（P〈0.05）.Gastric mucosa pathological examination showed that gastric inflammation integral and 14 C-urea breath test scores increased significantly after the training.Conclusion Stress could aggravate the injury of gastric mucosa,and increased Hp infection ratio of stomach.