^(13)C-尿素呼气试验值与反流性食管炎相关性探讨

Exploration of the Relationship between the Value of Delta Over Baseline of the ^(13)C-urea Breath Test and Reflux Esophagitis

目的探讨幽门螺杆菌(HP)^(13)C-尿素呼气试验(^(13)C-UBT)DOB值与反流性食管炎(RE)的相关性,评价根除HP治疗后RE的治疗效果。方法随机选择2016年1月~2016年12月在我院消化内科门诊就诊确诊为RE、^(13)C-UBT检测阳性(DOB值≥3.5dpm)的患者120例,回顾性分析其临床资料。患者分别按照Los Angeles分类(LA)法分级及按照临床症状严重程度评分,分析患者RE内镜分级及临床症状评分与DOB值的关系。再将120例患者按照1∶1比例随机分为观察组60例,给予根除HP治疗,对照组60例,给予常规治疗,疗程共8周。3个月后复查胃镜并行RE分级,记录两组患者临床症状缓解情况。结果 RE内镜分级与患者的DOB值水平呈负相关(P<0.01),RE临床症状评分与患者的DOB值水平呈负相关(P<0.01)。观察组60例患者治疗后复查^(13)C-UBT,52例阴性,8例阳性。观察组内镜下分级改善总有效率71.15%(37/52),高于对照组86.67%(52/60),P<0.05;观察组患者临床症状改善总有效率82.69%(43/52),与对照组88.33%(53/60)无明显差异,P>0.05。结论^(13)C-UBT的DOB值与患者内镜分级严重程度及临床症状评分呈负相关,HP感染可能是RE的保护因素。

Objective To explore the relationship between the value of delta over baseline（DOB） of the^13C-urea breath test of the helicobacter pylori infection and reflux esophagitis（RE）,and evaluate the endoscopic and clinical therapeutic effect of RE after HP eradication.Methods The clinical data was retrospectively analysed.One hundred and twenty patients were randomly enrolled in digestive outpatient clinics from January 2016 to December 2016,who underwent gastroscopy and were diagnosed with RE and were detected the HP-positive by^13C-UBT.The endoscopic manifestations and clinical symptoms of RE of every patient were respectively graded according to the Los Angeles classification（LA） and clinical severity.The correlation between the level of the DOB value of RE and endoscopic grade of LA,the score of clinical symptoms were compared.Then 120 patients were randomly divided by 1∶1,60 cases called observation group were given the eradication of HP infection,the other called control group given conventional treatment for 8 weeks.All the patients were re-examinated of gastroscopy after 3 months,and graded the endoscopic manifestations according to LA again.The observation group needed to be reviewed^13C-UBT,and the patients who failed to eradicate were excluded from the observation group.At the same time,the patients＇ improvement symptoms were recorded.Results There was a negative correlation between the RE＇s endoscopic grading and the level of the DOB value（P〈0.01）.And there was a negative correlation between the RE＇s the score of clinical symptoms and the level of the DOB value（P〈0.01）.In the observation group,60 cases were given the treatment of HP eradication,8 cases of whom failed to eradicate.The total effective rate under the endoscopic grade was 71.15%（37/52） in the observation group,and that was higher than the total effective rate of 86.67%（52/60） in the control group,and the difference was statistically significant（P〈0.05）.The total effective rate of the improvement symptoms was 82.69%（43/52）in the observation group,and 88.33%（53/60） in the control group,and the difference was not statistically significant（P〈0.05）.Conclusion The level of the DOB value is negatively correlated with the the severity of endoscopic grading and the score of clinical symptoms,so HP infection may be a protective factor of RE.