炎症性肠病患者幽门螺杆菌感染分析

Prevalence of Helicobacter pylori infection in patients with inflammatory bowel disease

目的分析炎症性肠病患者幽门螺杆菌(Hp)感染情况及Hp感染与炎症性肠病(IBD)患者的治疗史的相关性分析。方法选取2015年8月-2017年8月于医院消化内科接受治疗的IBD患者66例为研究对象,其中溃疡性结肠炎患者35例设为溃疡性结肠炎组(包括部分结肠受累15例及全结肠受累20例)、Crohn病患者31例设为Crohn病组;另选取同期有消化道不适症状但肠镜检查者66例为对照组。为保证研究的准确性,同时对两组患者给予14 C尿素呼气试验及Hp IgG抗体胶体金免疫层析快速诊断试验,用以检测炎症性肠病患者及正常组患者的幽门螺杆菌(Hp)感染率。结果 Hp感染与IBD患者的治疗史呈负相关(P=0.003)。接受过四环素(20.00%)、喹诺酮类(14.29%)药物治疗者的Hp感染率低于未接受四环素(60.00%)、喹诺酮类(62.50%)药物治疗者的Hp感染率(P<0.05)。由14 C尿素呼气试验结果可知,炎性肠病患者Hp感染率为19.70%(13/66)低于对照组为36.36%(24/66)(P=0.033);溃疡性结肠炎组幽门螺杆菌感染率为31.43%(11/35)高于Crohn病组6.45%(2/31)(P=0.011)。结论 IBD与Hp感染呈负相关,与溃疡性结肠炎患者相比,Crohn病患者Hp感染率更低,同时Hp对IBD疾病的发展起到一定的抑制及保护作用,具有一定的临床价值。

OBJECTIVE To investigate the prevalence of Helicobacter pylori（Hp）infection in patients with inflammatory bowel disease（IBD）and analyze the relationship between the Hp infection and the treatment history of the patients with IBD.METHODS A total of 66 patients with IBD who were treated in gastroenterology department from Aug 2015 to Aug 2017 were recruited as the study objects,35 patients who had ulcerative colitis were assigned as the ulcerative colitis group（including 15 cases of partial colon involvement and 20 cases of total colon involvement）,31 patients who had Crohn disease were set as the Crohn disease group.Meanwhile,66 patients who had gastrointestinal discomfort and received colonoscopy were chosen as the control group.To ensure the accuracy of the study,while the two groups of patients were given 14 C urea breath test and Hp IgG antibody colloidal gold immunochromatographic rapid diagnostic test so as to detect the prevalence rate of Hp infection in the patients with IBD and the patients of the control group.RESULTS The Hp infection was negatively correlated with the treatment history of the IBD patients（P=0.003）.The incidence rate of Hp infection was 20.00% in the patients who were treated with tetracycline,14.29% in the patients who were treated with quinolones,lower than60.00%in the patients who were not treated with tetracycline and 62.50%in the patients who were treated with quinolones（P〈0.05）.The result of the 14 C urea breath test showed that the incidence rate of Hp infection of the patients with IBD was 19.70%（13/66）,lower than 36.36%（24/66）of the control group（P=0.033）;the incidence rate of Hp infection of the ulcerative colitis group was 31.43%（11/35）,higher than 6.45%（2/31）of the Crohn disease group（P=0.011）.CONCLUSIONThe IBD is negatively correlated with the Hp infection,the incidence rate of Hp infection of the patients with Crohn disease is lower than that of the patients with ulcerative colitis,meanwhile,the Hp has certain inhibitory effect on development of IBD and protective effect,and it has certain clinical value.