根除幽门螺杆菌对胃增生性息肉疗效及血清学指标变化分析  

Treatment analysis and serologic findings of gastric hyperplastic polyps after eradication of Helicobacter pylori

作　　者：柳娟[1] 卢飞龙 陈刚[1] 杜凌[1] LIU Juan;LU Fei-long;CHEN Gang;DU Ling(Department of Gastroenterology,the Fourth Affiliated Hospital of Medical,Guangxi Medical University,545027Liuzhou Guangxi,China)

机构地区：[1]广西医科大学第四附属医院消化内科,广西柳州545027

出　　处：《临床消化病杂志》2023年第3期190-193,共4页Chinese Journal of Clinical Gastroenterology

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(No:Z20190046)。

摘　　要：[目的]分析根除幽门螺杆菌(Hp)治疗对胃增生性息肉(GHPs)患者疗效及血清学指标变化,并探讨除Hp感染以外息肉产生机制。[方法]收集143例Hp阳性GHPs患者资料,对临床特点、内镜表现、血清学指标变化进行回顾性研究。[结果]143例患者中113例(79%)患者成功根除Hp,分为根除Hp成功组及根除Hp失败组,2组患者治疗后息肉有反应率分别为84.0%、26.7%(P<0.05),2组息肉平均消退时间、消失时间比较差异无统计学意义,2组患者息肉复发率分别为0%、25.0%(P<0.05)。根除Hp成功患者中治疗后无反应者息肉直径大于治疗后有反应者(6.5 mm∶4.5mm,P<0.05),两者年龄、性别、息肉数量大致相仿。治疗后有反应者息肉主要位于胃体、胃窦,治疗后无反应者息肉主要位于胃底贲门,但两者息肉生长分布比较差异无统计学意义。治疗后无反应者在根除Hp之前(P<0.05)和之后12个月(P<0.05)G-17水平显著高于治疗后有反应者。在整个研究过程中,治疗后有反应者与治疗后无反应者血清PGⅠ和PGⅠ/Ⅱ水平相似。[结论]根除Hp治疗对于Hp阳性GHPs有效,息肉直径小根除治疗效果更好。GHPs患者可以联合检测血清G-17与PG水平指导疗效评估。除Hp感染以外,自身免疫性因素可能也与GHPs形成有关。[Objective]To investigate the effectiveness of Helicobacter pylori(Hp)eradication therapy on gastric hyper-plastic polyps(GHPs)and serologic findings.To explore the pathogenesis of GHPs except Hpinfection.[Methods]We retrospectively reviewed the medical records of GHPs in patients with Hpinfection.[Results]Of the 143patients,the rate of successful eradication of Hpinfection was 79%.The rate of responder in eradication of Hp success group was 84.0%,higher than the treatment failure group(26.7%,P<0.05).There was no significant difference in mean regression time and mean disappearance time of polyps between the two groups.There was lower recurrence rate in eradication success group than the failure group(P<0.05).The eradication of Hpin patients with non-responder polyp diameter was greater than the responder group(6.5mm vs 4.5mm,P<0.05).The responder and non-responder groups were similar with respect to age,gender,the number and distribution of polyps.The serum gastrin-17level was significantly higher in the non-responder group than in the responder group before and at 12months after the eradication of Hp.The responder and non-responder groups were similar with respect to the PGⅠlevel and the PGⅠ/Ⅱthroughout the study.[Conclusion]Hperadication therapy is effective for GHPs in patients with Hp,especially for those with the polyps.The combined detection of serum G-17and pepsinogen may be helpful for evaluation of treatment effect.Autoimmune factors may also be associated with GHPs formation.

关 键 词：胃增生性息肉 幽门螺杆菌 胃泌素-17 

分 类 号：R730.269[医药卫生—肿瘤]