反流性食管炎与幽门螺杆菌感染关系的探讨

To investigate the relationship between Helicobacter pylori and reflux esophagitis

目的 :探讨反流性食管炎与幽门螺杆菌感染的关系。方法 :选取胃镜诊断为食管炎的病人 14 88例 ,根据食管炎的Tytagat内镜分级将其分为Ⅰ～Ⅴ五级 ;取胃黏膜组织 ,用HP检测试纸行快速尿素酶测定 ,对照组慢性胃炎的病人 16 0 0例 ;消化性溃疡的病人 16 0 0例。结果 :反流性食管炎组幽门螺杆菌感染率 6 3.0 4 %。胃炎组感染率 6 5 .15 % ,同反流性食管炎组相比无差异 (P >0 .0 5 )。溃疡组感染率为 74 .5 0 % (P <0 .0 1)。Ⅰ～Ⅴ级反流性食管炎中反流性食管炎愈重HP检出率愈低(P <0 .0 1) ;反流性食管炎严重程度同HP感染严重程度成负相关 (P <0 .0 1)。结论 :1)幽门螺杆菌感染同反流性食管炎发病的关系尚有争议。 2 )幽门螺杆菌在反流性食管炎的发病过程中起着保护的作用。 3)反流性食管炎患者抗幽门螺杆菌的治疗应在反流性食管炎经治疗后症状消失而药物未停的情况下 ,谨慎进行。

Objective:To investigate the relationship between Helicobacter pylori(HP) and reflux esophagitis(RE). Methods: 1488 patients with esophagitis were diagnosed by gastroscope,and all of the patients were divided into five groups according to Tytagat. Biopsy specimens of each gastric mucosa were examined by rapid urease test assay.1600 patients with chronic gastritis and duodenal ulcer were also examined by rapid urease test assay. Results: The positive rates of Helicobacter pylori in reflux esophagitis ,chronic gastritis and duodenal ulcer were63.04%,65.15% and 74.50%( P >0.05 and P <0.01) respectively. There was a negative correlation, the lower the positive rates, the heavier the reflux esophagitis ( P <0.01), between the several levels of Helicobacter pylori and reflux esophagitis ( P <0.01) .Conclusion:1) There exists a dispute between Helicobacter pylori and episode procedure of reflux esophagitis. 2)Helicobacter pylori plays a protective role in episode procedure of reflux esophagitis.3)The eradication therapy for Helicobacter pylori should be taken more cautiously in the treatment of reflux esophagitis with continuing drug administration till its symptoms disappear.