摘要
目的 探讨反流性食管炎 (RE)与幽门螺杆菌 (Hp)感染之间的关系。 方法 ①对 6 8例内镜检查诊断为RE的患者进行Hp检测。分为Hp感染组和Hp阴性组 ;② 38例患者进行食管下括约肌压力检测 ;③对Hp感染的RE患者予根除Hp的三联疗法 (PPI+两种抗生素 ) 2周 ,继续服PPI 6周。检查Hp根除情况 ;④Hp阴性的RE者 ,仅给予PPI治疗 8周。结果 ①RE者中Hp感染 38例 (5 5 .9%) ,Hp阴性 30例 (4 4 .1%) ,两组无显著性差异 (P >0 .0 5 ) ;② 38例行食管测压者示食管下括约肌 (LES)有不同程度的减低 ,其中Hp感染 17例 (4 4 .7%) ,Hp阴性 2 1例 (5 5 .2 %) ;③病理检查示中 重度慢性胃炎 35例 (5 1.5 %) ,Hp感染组中 2 1例 (5 5 .3%) ,其中萎缩性胃炎 2例 ;Hp阴性组中 14例 (4 6 .7%) ,其中萎缩性胃炎 5例 ;④Hp感染组根除Hp后 ,39.4 %(15例 )患者反酸、烧心、胸骨后烧灼感有不同程度的加重 ;Hp阴性组治疗后症状明显减轻或消失。结论 ①目前没有足够的证据表明Hp感染与胃食管反流性疾病 (GERD)的发病有必然的关系 ;②Hp感染、萎缩性胃炎、反流性食管炎三者之间似乎没有必然的因果关系 ;③有Hp感染的GERD和RE患者 ,可以不必进行根除Hp的治疗。
Objective To analyze and study the association between reflux esophagitis (RE) and Helicobacter pylori(Hp) infection.Methods 68 patients with RE diagnosed by endoscopy were detected for presence of Hp infection.They are divided into two groups:Hp positive and negative groups.The pressure of esophagus of 38 patients with RE were detected.Hp positive patients were treated with two week triple therapy (omeprazol,amoxycillin and tinidazole),then successive omeprazol for six weeks.The eradication of Hp was evaluated by 13 C breath test.Hp negative group was treated with omeprazol for eight weeks.Results Of the total RE patients,Hp positive patients were 55.9%(38/68),Hp negative patients were 44.1% (30/68).There was no significant difference between Hp positive and negative group ( P >0.05).The pressure of esophagus in 38 patients was lower than normal.There were 17 Hp positive patients (44.7%) and 21 Hp negative patients (55.2%) among them.There were 35 moderate to severe gastritis in 68 patients with RE (51.5%).21 patients (55.3%) in Hp positive group (2 were atrophic gastritis).14 patients (46.7%) in Hp negative group (5 were atrophic gastritis).After therapy,the symptoms (reflux acid,heartburn,chest pain) of 15 patients in Hp positive group were more severe than before.The symptoms in all Hp negative patients were relieved.Conclusions There was no significant relationship between Hp infection and reflux esophagitis.There was no association of Hp infection with atrophic gastritis and reflux esophagitis.The Hp positive patients with GERD and RE needn't the therapy to eradicate Hp if there is no clinic necessity.
出处
《北京医学》
CAS
北大核心
2003年第3期170-172,共3页
Beijing Medical Journal
