幽门螺杆菌在胃食管反流病发病中的作用

The Role of Helicobacter Pylori in the Pathogenesis of Gastroesophageal Reflux Disease

目的探讨幽门螺杆菌(Hp)在胃食管反流病(GERD)发病中的作用,为临床诊治GERD提供参考。方法选取2016年2月~2018年12月我院收治的胃食管反流病患者85例,设为GERD组,另选同期我院体检健康者30人为对照组,14C呼气试验法进行Hp检测,比较两组Hp感染阳性率、GERD不同症状程度者Hp感染阳性率以及反流性食管炎(RE)不同程度者Hp感染阳性率。结果GERD组Hp感染阳性率(54.12%)高于对照组(46.67%),差异无统计学意义(P>0.05);GERD轻度症状组、中度症状组、重度症状组及极重度症状组Hp感染阳性率分别为55.00%、52.00%、54.55%、55.56%,组间比较,差异无统计学意义(P>0.05);RE患者LA-A组、LA-B组、LA-C组及LA-D组Hp感染阳性率分别是57.14%、55.56%、47.06%、46.15%,组间比较差异无统计学意义(P>0.05)。结论幽门螺杆菌感染在胃食管反流病发生和发展过程中可能无相关性,但对于Hp阳性的GERD患者也应根据实际情况实施根除Hp治疗,以减少恶变几率。

Objective To investigate the role of Helicobacter pylori(Hp)in the pathogenesis of gastroesophageal reflux disease(GERD)and provide reference for clinical diagnosis and treatment of GERD.Methods 85 patients with gastroesophageal reflux disease admitted to our hospital from February 2016 to December 2018 were enrolled in the GERD group.Another 30 healthy people in our hospital were selected as the control group,and the 14C breath test method was used for Hp detection.The positive rate of Hp infection,the positive rate of Hp infection in different degrees of GERD,and the positive Hp infection in different degrees of RE were compared between the two groups.Results The positive rate of Hp infection in GERD group(54.12%)was higher than that in control group(46.67%),the difference was not statistically significant(P>0.05);GERD mild symptom group,moderate symptom group,severe symptom group and very severe symptom group Hp the positive rates of infection were 55.00%,52.00%,54.55%,and 55.56%,respectively.There was no significant difference between the groups(P>0.05).The positive rates of Hp infection in LA-A group,LA-B group,LA-C group and LA-D group were 57.14%,55.56%,47.06%,and 46.15%,respectively.There was no significant difference between the groups(P>0.05).Conclusion Helicobacter pylori infection may not be associated with the development and progression of gastroesophageal reflux disease.However,patients with Hp-positive GERD should also be treated with Hp eradication according to the actual situation to reduce the risk of malignant transformation.