反流性食管炎与幽门螺杆菌感染的相关性研究  

The relation of reflux esophagitis and H. pylori infection

作　　者：李渊[1] 周丽雅[1] 林三仁[1] 金珠[1] 崔荣丽[1] 王洪源[2] 

机构地区：[1]北京大学第三医院消化科,北京100191 [2]北京大学医学部流行病与卫生统计学系,北京100191

出　　处：《中国实用内科杂志》2009年第9期833-835,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的研究反流性食管炎(RE)胃黏膜病理改变和幽门螺杆菌(H.pylori)感染的差异。方法选取从2007年1月至6月在北京大学第三医院消化科行胃镜检查证实的RE患者178例,按洛杉矶标准进行分级后分为A、B、C、D4组,并取胃黏膜组织行病理检查,对比各组的H.pylori感染率、感染部位、感染程度的差异以及胃炎的类型(浅表性胃炎和萎缩性胃炎)及活动度的差异。结果(1)反流程度越重,患者年龄越大(A组与B组比较,P<0.05;A组与C组或D组比较,P<0.01;B组与C组或D组比较,P<0.01);(2)反流程度越重,胃窦的H.pylori感染率及感染程度越轻(分别为P=0.002及P=0.002),胃窦的炎症越轻(P=0.003);在反流程度不同的各组中,胃体的H.pylori感染率(P=0.106)、感染程度(P=0.071)以及胃体的炎症程度差异无统计学意义(P=0.427)。结论H.pylori感染与RE形成有负相关性;反流程度越重,胃窦的炎症越轻。Objective To compare the pathological changes of gastric mucosa and infection of H. pylori in different severity grades of RE. Methods 178 patients with reflux esophagitis were enrolled who were diagnosed by gastroscopy in our centers from Jan. to Jun. in 2007. The severity grade of EE was according to Los Angles standard. All the patients received biopsies from gastric body and antrum, then received pathologic examinations. Pathological changes were compared：prevalence, density and pattern of colonization of H. pylori infection ;2 types （superficial and atrophic） and activity of gastritis of gastric mucosa in different severity grades of RE. Results （ 1 ） Patients with severe esophagitis were older than those with mild esophagitis. （2） In patients with severe esophagitis, the prevalence and density of H. pylori, the degree of inflammation in gastric antrum were significantly lower than those with mild esophagitis （ P = 0. 002, P = 0. 002, P = 0. 003, respectively） , but the prevalence and density of H. pylori, the degree of inflammation in gastric body were not different statistically from those with mild esophagitis （P = 0. 106, P = 0. 071, P = 0. 427, respectively）. Conclusion H. pylori infection has an inverse correlation with the formation of RE;The more severe the RE is, the lower the degree of inflammation in gastric antrum is.

关 键 词：幽门螺杆菌 反流性食管炎 胃炎 

分 类 号：R5[医药卫生—内科学]