自身免疫性胃炎根除幽门螺杆菌后的相关研究

目的探讨自身免疫性胃炎根除幽门螺杆菌(Hp)后对血清壁细胞抗体(PCA)、血清胃泌素、血清维生素B12、胃内pH值的影响。方法 104例患者均经胃镜及血清壁细胞抗体(PCA)诊断为自身免疫性胃炎(AIG),Hp感染由13C尿素呼气试验或快速尿素酶试验检查证实。患者随机分为两组:治疗组54例,对照组50例。治疗组采用经典根除幽门螺杆菌方案,共服药10d。治疗结束后4～8周,检测Hp根除情况。对照组不用任何对Hp有影响的药物,且与治疗组在同一时间作Hp检测、胃镜及PCA、血清胃泌素、血清维生素B12等检查。结果治疗组Hp根除率为83.8%,对照组根除率为0%(χ2=76.2,P<0.01),在患者根除Hp后PCA阳性率下降,转阴率为72.2%,对照组PCA转阴率为0%(χ2=57.3,P<0.01),具有统计学意义。治疗组治疗与对照组比较自身免疫性胃炎根除Hp后,PCA阳性率明显下降,血清胃泌素降低,胃内pH值及血清维生素B12升高(P<0.01),均具有统计学意义。治疗组上腹部胀痛症状改善明显,对照组中原有上腹部胀痛症状无改善,治疗组贫血明显改善,对照组贫血改善不明显。结论自身免疫性胃炎根除Hp后,PCA阳性率下降,血清胃泌素降低,胃内pH值及血清维生素B12升高。对于Hp感染的自身免疫性胃炎建议根除Hp。

The research about autoimmune gastritis after helicobacter pylori be eradicated

Objective To explore the influence of parietal cell antibody(PCA),serum gastrin,and serum vitamin B12,the stomach pH value after helicobacter pylori(Hp) eradicated.Methods 104 patients were diagnosed autoimmune gastritis(AIG) by gastroscope and serum wall cells antibody(PCA),Hp infection by 13C urea breath test or rapid urease tests.Patients were divided into two groups:treatment group of 54 cases,control group of 50 cases.The treatment group using classical helicobacter pylori eradication scheme,a total of 10 day’s medicine.After treatment 4 to 8 weeks,detected Hp eradication.The control group did not have any drugs to influence Hp,and at the same time for Hp detection,endoscopy and PCA,serum stomach secrete element,serum vitamin B12.Results The treatment group’s Hp eradicate rate was 83.8%,the control group of Hp eradicate rate was 0%(χ2=76.2,P<0.01).After Hp was eradicated,the negative conversion rate was 72.2%,the control group’s negative conversion rate was 0%(χ2=57.3,P<0.01),with statistical significance.In treatment group and control group was autoimmune gastritis eradicate Hp,PCA positie declined obviously,and serum stomach secrete element in the lower stomach pH value and serum vitamin B12 increases(P<0.01).The treatment group on abdomen bilge painful symptoms improved,in the control group,the original abdomen bilge painful symptoms without improving.The treatment group anemia markedly improved,and the control group anemia improved not obviously.Conclusion After Hp is eradicated in AIG,PCA’s negative conversion rate decrease,Gastrin reduce,pH in the stomach and vitamin B12 rise.It is suggested that the patients with autoimmune gastritis should eradicate Hp.