幽门螺杆菌感染与消化性溃疡和反流性食管炎的关系

Relationship among helicobacter pylori infection and peptic ulcer and reflux esophagitis

目的比较幽门螺杆菌在消化性溃疡(GU和DU)和反流性食管炎(RE)中检出率的不同, 探讨幽门螺杆菌对RE的作用。方法入选病例为胃镜室检查且具有Hp检测结果的下列患者:RE,RE+GU,GU,RE+DU和DU,共2 018例,1 240例患者进入分析,其中RE 287例,RE+GU 13例,GU 225例,RE+DU 31例,DU 684例,各组年龄差异无显著性(P=0.20)。结果Hp检出率分别为RE 35.2%,RE+GU 38.5%,GU 56.4%,RE+DU 54.8%,DU 70.9%。Hp在GU中的检出率高于在RE和RE+GU中的检出率,Hp在RE+DU中的检出率高于其在RE中的检出率(P=0.027),但是低于Hp在DU的检出率(P=0.047)。结论Hp可能对食管具有潜在的保护作用。

Objective: To investigate H.pylori detection rate in reflux esophagitis, reflux esophagitis with peptic ulcer and peptic ulcer alone and to evaluate the effect of Helicobacter pylori on reflux esophagitis. Methods: 2 108 patients who were underwent endoscope were enrolled in the study and divided into 5 groups: group 1, reflux esophagitis; group 2, reflux esophagitis with gastric ulcer; group 3, gastric ulcer alone; group 4, reflux esophagitis with duodenal ulcer; group 5, duodenal ulcer alone. H.pylori infection was diagnosed. After proportioning by age, 1 240 patients were analyzed. Results: H.pylori detection rate was 35.2%,38.5%, 56.4%, 54.8% and 70.9%, respectively in these 5 groups (P<0.001). Only 5.42% of patients with gastric ulcer were suffering from reflux esophagitis, and 4.30% of patients with duodenal ulcer were suffering from reflux esophagitis. H.pylori detection rate was higher in group 4 than that in group 1 (P=0.027) and was lower than that in group 5 (P=0.047). There was no significant difference in H.pylori detection rates between group 1 and group 2 (P=0.511), group 2 and group 3 (P=0.163). Conclusions: Although peptic ulcer may coexist with reflux esophagitis, it isn′t denied that H.pylori has a potential protective effect on esophagus.