根除幽门螺杆菌与胃食管反流病相关性分析

目的分析幽门螺杆菌阳性的十二指肠球溃疡患者中，根除幽门螺杆菌后胃食管反流病发病率的情况，了解两者的相关性。方法经胃镜、24h食道pH监测、^14C-尿素呼气试验、快速尿素酶试验、Warthin—starry染色检查，将50名Hp阳性不伴GERD的十二指肠溃疡患者分为两组，A组（根除Hp组）；B组（对照组）：单纯抑酸治疗。疗程结束后，观察Hp根除及GERD发生情况。结果治疗组幽门螺杆菌根除率为92％。疗程结束1周后，Hp根除者与对照组GERD发生率均为0；疗程结束3个月后，Hp根除患者中GERD发生率为8．7％，对照组GERD发生率为8．3％，两组间胃食管反流病发生率无显著差别。结论根除幽门螺杆菌并不会显著增加或减少胃食管反流病的发病率，提示幽门螺杆菌可能既不具有对胃食管反流病的保护作用，也不具有加重胃食管反流病的作用，幽门螺杆菌与胃食管反流病无明显相关性。溃疡治愈后，胃食管反流病的发生，可能与强抑酸剂停用后酸分泌反跳作用强化有关，而与幽门螺杆菌是否根除无关。

Analysis of Relationship between Helicobacter Pylori Eradication and Gastro-esophageal Reflux Disease

Objective To investigate the relationship between Hp infection and GERD by analyzing the incidence of GERD in patients with duodenal ulcer after eradication of Hp. Methods All patients underwent endoscopy,24-hour esophageal pH-monitoring, ^14C-urease breath test, rapid urease test and Warthin-starry stain. 50 patients with duodenal ulcer and Hp-positive without GERD were enrolled, then they were divided into 2 groups,group A：patients who underwent Hp eradication therapy. Group B：patients who did not undergo eradication therapy, simple omeprazole therapy. To observe Hp eradication rate and the incidence of GERD at the end of therapy. Results Hp eradication rate was 92% in the therapy group. The estimated incidence of GERD in every group at the end of therapy after 1 week was 0. The incidence of GERD at the end of therapy after 3 months was 8.7% in group A, and 8.3% in the control group. There was no significant difference in the comparison of the two groups. Conclusion Eradication of Hp does not increase or decrease the prevalence of GERD. This study suggests that Hp has no protection against GERD and it also cannot accelerate the development of GERD. Maybe there is no relationship between Hp infection and GERD. The development of GERD maybe is caused by bouncing gastric acid Hyper-secretion when antisecretory agents are stopped after ulcer healing.