幽门螺杆菌感染对反流性食管炎病程影响的临床研究  

Influence of Helicobacter pylori infection in the course of reflux esophagitis

作　　者：张金钊 

机构地区：[1]大冶市中医医院消化内科,湖北大冶435100

出　　处：《临床消化病杂志》2015年第5期286-288,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]研究幽门螺杆菌(Hp)感染对反流性食管炎(RE)病程的影响。[方法]将132例RE患者(RE组)与130例无消化道症状的健康体检者(对照组)的Hp检测结果进行比较。将RE组患者根据洛杉矶分级分为ABCD级,AB级为RE轻度组、CD级为RE重度组,比较2组Hp感染情况;同时依据Hp检测结果将RE组分为Hp阳性组、Hp阴性组,比较2组Barrett食管(BE)的发生率;根据Hp阳性组患者经2周Hp根除治疗后的结果分为Hp根除组、Hp未根除组,1年后进行2组RE复发率比较。[结果]RE组的Hp感染率为36.36%,对照组Hp感染率为63.85%。2组比较差异有统计学意义(!2=19.79,P<0.05)。Hp阳性组BE的发病率为2.08%,明显低于Hp阴性组的13.10%,差异有统计学意义(!2=4.48,P<0.05);RE轻度组Hp感染率为49.30%,RE重度组Hp感染率为23.31%,2组比较差异有统计学意义(!2=11.10,P<0.05);Hp根除组、Hp未根除组1年RE复发率分别为37.5%、12.5%,2组比较差异有统计学意义(!2=4.00,P<0.05)。[结论]Hp感染对RE有保护作用,与病情的严重程度呈负相关,RE炎症程度越重,Hp感染率越低;还可减少BE的发生率,降低RE病程的严重性。临床需根据实际情况分析利弊,选择是否根除Hp。[Objective]Study the influence of Helicobacter pylori（H p）infection in the course of reflux esophagitis（RE）.[Methods]Total 132 cases of RE diagnosed by gastroscopy from January -December 2012 in our hospital were observed.H p were detected at the same time.The total H p infection rate in RE pa‐tients were compared with 130 cases of healthy controls.RE were divided into A ,B ,C ,D levels according to the Los Angeles grading.A and B level were defined the mild group ,C and D group were defined severe group.The H p infection between the two groups was compared.At the same time ,RE condition was com‐pared between the patients with or without H p infection.H p positive patients were randomly divided into H p eradication group and the control group ,the recurrence rate after one year was compared.[Results]Pa‐tients in RE group with H p infection was 36.36% .While the H p infection rate in control group was 63.85% （ c2 =19.79 ,P〈0.05）.H p infection rate in RE mild group was 49.30% ,and 23.31% in severe group.There was significant difference between the two groups（ c2 =11.10 ,P〈0.05）.Barrett＇s esophagus （BE）morbidity in patients with H p infection was 2.08% ,significantly lower than the 13.10% in H p nega‐tive group.The difference was statistically significant（ c2 =4.48 ,P〈0.05）.The recurrence rate in eradica‐tion group was 37.5% and 12.5% in the without treatment group.There was significant difference be‐tween the two groups（ c2 =4.00 ,P〈0.05）.[Conclusion]H p infection have a protective effect on RE ,and is negatively correlated with the severity of RE.In the patients with severe ,H p infection rate is lower.It can reduce BE incidence and reduce the seriousness of the RE course.

关 键 词：反流性食管炎 幽门螺杆菌 BARRETT食管 

分 类 号：R571[医药卫生—消化系统]