幽门螺杆菌感染与功能性消化不良亚型关系的探讨

目的 观察不同类型功能性消化不良(Function dyspepsia,FD)的幽门螺杆菌(Helicobacter pylori,HP)感染率的差异,以及抗Hp治疗后各型FD患者症状的改善程度,以此探讨Hp与FD各型的关系.方法 725例FD并因诊断有Hp感染,给予一个疗程的抗菌治疗,问卷询问患者治疗前及停药后1个月和6个月后的症状及其变化,并评价其症状改善程度(程度分为:明显改善,一般改善,无变化,复发).~(14)C-尿素呼气试验复查Hp感染状况.结果 FD四型之间Hp感染率无明显差异,溃疡样型、动力障碍型、混合型抗Hp治疗后1个月Hp根除患者症状明显改善、一般改善均显著多于Hp未根除者,反流样型也有类似表现,但无统计学差异.6个月后溃疡样型、动力障碍型、混合型这三型症状改善的Hp根除者大多数症状继续得到改善,只有7.1%、15.2%和10.8%的患者出现症状复发,而反流样型症状复发率达32.0%,它们之间有显著差异.结论 Hp可能是FD的一个重要致病因素,尤其与溃疡样型、动力障碍型、混合型关系密切.抗Hp感染是治疗Hp阳性FD(反流样型除外)的一个重要手段.

Relationship between infection of Hp and subgroup of functional dyspepsia

Abstract] Objective To study the relationship between infection of Hp and subgroup of functional dyspepsia. Methods 998 of FD patients diagnosed by endoscopy were entered into the study and divided into symptom-base subgroups (ulcer-like, dysmotility-like, reflex-like and unspecified dyspepsia) . 725 of 998 patients were treated with triple therapy and Hp re-examined and Symptoms evaluated four and 24 weeks after the treatment. Results (1) No differences of rate of Hp infection were observed among 4 subgroups of FD 4 weeks after the treatment. (2) In three subgroups ulcer-like, dysmotility-like, and unspecified dyspepsia Hperadicated cases had symptom improved more significantly than the noneradicated cases had, in subgroup of reflux-like Hp-eradicated cases had symptom more than noneradicated cases had, but not significantly. (3) Hp eradicated cases got only 7.1%, 15.2%, 10.8% about rate of symptom-recrudesced, respectively in the three subgroups of ulcer-like, dysmotility-like, and unspecified dyspepsia after 24 weeks from the end of the treatment, while rate of symptom-recrudesced were up to 32.0% in the subgroup of reflux-like, between them there were remarkable difference. Conclusion Antibacterial therapy in beneficial to symptomatic Hp-related FD except the subgroup of reflux-like, Hp might be play an important role in the three subgroups of ulcer-like, dysmotility-like, amd unspecified dyspepsia of FD.