幽门螺杆菌感染与内镜下部分胃部疾病相关性分析

The correlation between Helicobacter pylori infection and some gastric diseases under endoscopy

目的分析H.pylori感染与胃部相关疾病的临床及内镜下表现的关系,提高对H.pylori的认知,从而为疾病的治疗提供依据。方法选取2016年1月至2017年12月上海交通大学医学院附属瑞金医院北院消化内镜中心收治的胃息肉、疣状胃炎、消化性溃疡患者进行研究,另选上消化道癌(包括食管癌和胃癌)患者分析H.pylori感染情况。结果收集2 589例患者,胃息肉组中炎性增生性及腺瘤性息肉H.pylori感染率分别为24.23%、2.19%,<50岁年龄段感染率最高,达27.14%,且胃窦、胃角、贲门部位感染率分别为25.15%、34.78%、34.78%。消化性溃疡组H.pylori感染率中十二指肠球部较高,达74.48%,男性患者感染率高于女性,且年龄越轻感染率越高,组间比较差异有统计学意义(P<0.05)。恶性肿瘤组,胃癌H.pylori感染率较高,达11.11%,且年龄越大感染率越高。结论 H.pylori感染与胃部疾病的类型、病理、年龄段及部位相关,临床上早期诊断、早期治疗H.pylori对于胃部疾病的发展及转归意义重大。

Objective To analyze the relationship between H.pylori infection with clinical and endoscopic manifestations of gastric related diseases, and to improve the understanding of H.pylori, so as to provide a basis for the treatment of the disease. Methods From Jan. 2016 to Dec. 2017, patients with gastric polyp, verrucous gastritis and peptic ulcer admitted to the Center of Digestive Endoscopy, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine were selected for the study, and patients with upper gastrointestinal cancer(including esophageal cancer and gastric cancer) were selected to analyze H.pylori infection. Results In 2 589 cases, the infection rates of H.pylori in inflammatory proliferative and adenomatous polyps were 24.23% and 2.19%. The highest infection rate was 27.14% in the age less than 50 years old group. The infection rates in antrum, angle and cardia were 25.15%, 34.78% and 34.78%. The infection rate of H.pylori in peptic ulcer group was higher in duodenal bulb(74.48%). The infection rate of male patients was higher than that of female patients, and the younger the age, the higher the infection rate. The infection rate of H.pylori in gastric cancer group was 11.11%, and the older the age, the higher the infection rate. Conclusion H.pylori infection is related to the type, pathology, age and location of gastric diseases. Early clinical diagnosis and early treatment of H.pylori are of great significance for the development and prognosis of gastric diseases.