幽门螺杆菌与胃食管反流病的关系研究

The relationship between Helicobacter pylori and gastroesophageal reflux disease

目的 探讨幽门螺杆菌 (Hp)感染与胃食管反流病 (GERD)的关系。方法 用瑞典 PC Polygraf HR、CTD- pigitraperMK- 携带 p H监测仪 ,分别测定 Hp(+)组 (16例 )和 Hp(- )组 (2 0例 )病人的食管下段压力、2 4 h p H值 ,进行对比分析。结果 Hp(+)组病人的食管下段括约肌压力 (L ESP)、松弛率 (L ESRR)、松弛压 (L ESRP)、食管上段括约肌压力 (UESP)分别为 (15 .1±8.5 ) mm Hg(1mm Hg=0 .133k Pa)、- (1.3± 5 .4 ) m m Hg、(10 0 .6± 38.7) %、(70 .7± 4 1.9) m m Hg。 Hp(- )组分别为 (2 2 .3± 14 .4 )mm Hg、(0 .6± 2 .7) mm Hg、(99.3± 15 .5 ) %、(6 0 .5± 4 8.2 ) m m Hg。两组无显著性差异 (P >0 .0 5 ) ;2 4 h p H值 :p H<4的总时间百分率 ;p H<4的立位总时间百分率、p H<4卧位总时间百分率 ;p H<4的反流次数 ,p H<4反流持续≥ 5 min次数 ;最长反流持续时间 ,6项指标算出的 De Meester总分 ,Hp(+)组为 17.1,Hp(- )组为 19.0。两组无显著性差异 (P >0 .0 5 )。结论 幽门螺杆菌感染对食管下段压力及 2 4 h p H值无明显影响。

Objective To study relationship between infection of Helicobactor pylori (Hp) and gstroesophageal reflux disease(GERD).Methods The lower esophageal sphincter pressure (LESP) and twenty-four hour pH monitoring (24h pH) of 16 patients with Hp (+) and 20 patients with Hp(-) for GERD were measured with a PC Polygraf HR system and CTD-pigitraper MK-Ⅲ portable pH monitoring unit.Results Lower esophageal sphincter pressure,lower esophageal sphincter releasing rate (LESRR),lewer esophageal sphincter releasing pressure (LESRP),upper esophageal sphincter pressure (UESP) of the group with Hp(+) were respectively (15.1±8.5)mmHg,-(1.3±5.4)mmHg,(100.6±38.7)%,(70.7±41.9)mmHg.While the those with Hp(-)were respectively(22.3±14.4)mmHg,(0.6±2.7)mmHg,(99.3±15.5)%,(60.5±48.2)mmHg.There was not significant difference in the comparison of the two groups (P>0.05).24hpH:pH<4 all time percent,pH<4 up-position all time percent,pH<4 prone-possition all time percent,pH<4 reflux continue >5 times、continuing time of the longest reflux,were counted as all De Meester score above 6 indexs.The group with Hp(+)was 17.1,while the group with Hp(-) was 19.0.There was no significant difference in the comparison of the two groups (P>0.05).Conclusion The infection of Hp has no remarkable influence on the LESP and the 24h pH.