四联疗法治疗幽门螺旋杆菌相关性十二指肠球炎疗效分析

目的 比较标准四联与三联法治疗幽门螺旋杆菌相关性十二指肠球炎临床疗效。方法 选择2017年5月~2018年5月我院收治的幽门螺旋杆菌相关性十二指肠球炎患者96例,随机分为观察组和对照组,每组48例。观察组采用兰索拉唑、克拉霉素、阿莫西林、果胶铋标准四联治疗,对照组采用兰索拉唑、克拉霉素、阿莫西林标准三联治疗。比较两组患者Hp根除率、复发率及不良反应情况。结果 观察组患者Hp根除率为91.67%,高于对照组75.00%,差异具有统计学意义（P＜0.05）。观察组患者Hp复发率为10.42%,低于对照组的20.83%,差异具有统计学意义（P＜0.05）。观察组不良反应发生率为4.16%,低于对照组的6.25%,但组间比较,差异无统计学意义（P＞0.05）。结论 标准四联疗法治疗幽门螺旋杆菌相关性十二指肠球炎,Hp根除率较高,复发率低,且不增加不良反应发生率。     

复方嗜酸乳杆菌联合常规四联疗法治疗幽门螺旋杆菌感染消化性溃疡的疗效

目的 观察复方嗜酸乳杆菌联合常规四联疗法治疗幽门螺旋杆菌（Hp）感染消化性溃疡的疗效。方法 选择2018年5月~2019年5月在我院诊治的幽门螺旋杆菌感染消化性溃疡患者112例,采用随机数字表法分为对照组和观察组,各56例。对照组采用常规四联疗法治疗,观察组在对照组基础上加用复方嗜酸乳杆菌治疗,比较两组临床治疗总有效率、临床症状（反酸、上腹痛、饱胀、呕吐）评分、Hp根除率以及临床不良反应发生情况。结果 观察组治疗总有效率为94.64%,高于对照组的80.35%,差异有统计学意义（P＜0.05）;观察组反酸、上腹痛、饱胀、呕吐症状评分均低于对照组,差异有统计学意义（P＜0.05）;观察组Hp根除率为92.85%,高于对照组的78.57%,差异有统计学意义（P＜0.05）;观察组不良反应发生率为3.57%,低于对照组的16.07%,差异有统计学意义（P＜0.05）。结论 复方嗜酸乳杆菌联合常规四联疗法治疗Hp感染消化性溃疡疗效确切,可促进Hp根除,有助于减轻临床症状,降低临床症状评分,且临床不良反应少。     

幽门螺杆菌根除治疗对幽门螺杆菌阳性的功能性消化不良患者疗效分析

目的 探讨幽门螺杆菌根除治疗对幽门螺杆菌阳性的功能性消化不良（FD）患者疗效。方法 选取2015年1月~2017年1月在本院就诊的幽门螺杆菌阳性的功能性消化不良患者82例,随机分为观察组和对照组。对照组40例采取常规药物（莫沙必利+奥美拉唑）治疗,观察组42例采取四联疗法（兰索拉唑+阿莫西林+克拉霉素+胶体次枸橼酸铋）杀灭幽门螺杆菌治疗,比较两组患者症状改善、临床疗效和不良反应发生情况。结果 两组患者治疗后临床症状积分较治疗前均明显降低,观察组治疗后临床症状积分为（2.71±1.86）分,低于对照组的（8.45±1.92）分,差异有统计学意义（P＜0.05）;观察组不良反应发生率（11.90%）明显低于对照组（22.50%）,差异有统计学意义（P＜0.05）;观察组总有效率（92.86%）明显高于对照组（75.00%）,差异有统计学意义（P＜0.05）。结论 对于幽门螺杆菌阳性的功能性消化不良患者而言,采取四联疗法杀灭幽门螺杆菌,能更加明显改善其临床症状,提高治疗效果,减少不良反应情况,具有临床推广应用价值。     

幽门螺旋杆菌感染与小儿慢性荨麻疹

目的　探讨幽门螺旋杆菌与慢性荨麻疹之间的关系。方法　应用酶联免疫吸附 (ELISA)法对 2 4例慢性荨麻疹患儿及 30例健康体检儿童进行幽门螺旋杆菌 (Hp -IgG)检测 ,并对抗Hp -IgG抗体阳性的荨麻疹患儿进行了14 C尿素呼吸试验(14 C -UBT) ,2项均阳性患儿采用了根除Hp的治疗。结果　慢性荨麻疹组 2 4例中 11例Hp -IgG阳性 ,阳性率 4 5 .8% ,对照组4例抗Hp -IgG抗体阳性 ,两组比较差异有显著意义 (χ2 =7.0 2 ,P <0 .0 1)。 2 4例荨麻疹患儿Hp -IgG及14 C -UBT均阳性者10例 ,给予根除Hp的治疗后 4周随访 ,所有的患儿皮疹消退 ,复查14 C -UBT均为阴性。继续随访 1年 ,其中 8例未再复发 ,2例再次出现皮疹 ,经再次治疗后皮疹完全消失 ,未再复发。结论　幽门螺旋杆菌感染与慢性荨麻疹的发病有关。     

大黄、黄连、黄芩联合三联序贯治疗Hp感染的疗效分析

目的 对比大黄、黄连、黄芩三味药联合三联序贯治疗Hp感染与三联治疗Hp的临床疗效。方法 把解放军武汉总医院门诊行14C呼气试验检测Hp为阳性的患者67例,随机分为两组,A组:标准三联组（耐信+克拉霉素+阿莫西林）,疗程10 d;B组:先用大黄、黄连、黄芩治疗1周再用标准三联治疗10 d。抗Hp治疗停药4周后复查14C呼气试验。比较各组Hp根除率。结果 A组Hp根除率为51.56%,B组Hp根除率为85.29%,两组差异有统计学意义（P＜0.05）。结论 中药大黄、黄连、黄芩联合标准三联序贯治疗Hp感染的根除率高于三联治疗Hp感染。     

2808例幽门螺旋杆菌感染检测结果分析

通过对深圳沙井街道市民门诊体检者血标本幽门螺杆菌(Hp)抗体检测,了解了本地区人群中Hp的感染情况。报告如下。材料和方法1标本来源收集2011年1月至12月2808名深圳沙井街道市民门诊体检者血标本,男性1411名,女性1397名。其中<15岁173名(男性103名,女性70名),15～24岁461名(男性193     

根治幽门螺旋杆菌序贯疗法优于标准药物治疗

意大利S．Orsola医院的DinoVaira医生及其同事4月17日《内科学年鉴》（AnnInternMed，2007；146：556—563．）上报告，对于根治幽门螺旋杆菌，序贯使用几种药物治疗比标准三联药物治疗更加有效。     

残胃黏膜幽门螺旋杆菌感染与IL-8 mRNA表达的关系

目的:探讨不同部位残胃黏膜幽门螺旋杆菌(Helicobacterpylori,Hp)感染与IL8mRNA表达的关系。方法:对58例残胃患者进行胃镜检查,于吻合口和胃体大弯处,采用两点取材法取材进行胃镜活检。活检标本Hp的感染采用HE和Giemsa染色法检查。活检标本中IL8mRNA表达水平采用实时半定量PCR法检测。结果:58例残胃患者中,38例感染Hp(65.5%)。34例以BI式吻合者中,残胃体部Hp感染阳性者IL8mRNA表达的水平,明显高于Hp感染阴性者的表达水平,分别为0.11±0.07和0.02±0.01(P<0.05);24例BII式吻合者,无论是残胃体部还是吻合口处,Hp感染阳性者IL8mRNA表达的水平,均明显高于Hp感染阴性者的表达水平(吻合口处IL8mRNA表达为:0.32±0.24和0.02±0.01;残胃体部为:0.18±0.08和0.01±0.01)(P<0.05)。结论:残胃黏膜Hp的感染可诱导IL8mRNA表达。残胃体部IL8mRNA的表达主要与Hp感染有关;吻合口处IL8mRNA表达,除与Hp感染有关外,也受胆汁反流影响。     

吸烟饮酒对胃部疾病幽门螺旋杆菌感染的影响

幽门螺旋杆菌（helicobacter pylori,Hp）是慢性胃炎、消化性溃疡、胃癌的主要致病因子之一。Hp阳性患者胃窦炎症活动性显著重于Hp阴性者,多数国家超过90%的十二指肠溃疡患者和将近70%的胃溃疡患者伴有Hp感染[1]。     

应用荧光定量PCR法检测病理组织中幽门螺旋杆菌感染

目的探讨荧光定量PCR方法检测病理组织中幽门螺旋杆菌（Hp）的效果,为临床Hp感染诊断提供快速有效的检测方法。方法应用荧光定量PCR法及苯胺蓝染色法分别对106例临床送检胃窦黏膜组织标本进行幽门螺旋杆菌检测,对检测结果进行对比分析。结果在106例胃窦标本中,荧光定量PCR法检测阳性例数68例,阳性率为64．2％,苯胺蓝染色法检测阳性例数46例,阳性率为43．4％。两种方法检测阳性率比较有显著性差异（P〈0．05）。结论荧光定量PCR技术用于检测病理组织中幽门螺旋杆菌,具有灵敏度高、特异性强的特点,对确诊胃镜活检标本中幽门螺旋杆菌感染具有重要应用价值。     

Eradication therapy of Helicobacter pylori infection

Helicobacter pylori(H. pylori) infection is recognized to be a pathogen of various gastro-duodenal diseases. Eradication therapy of H. pylori reduces the recurrence of gastro-duodenal ulcer, and improves gastritis histologically. Recently, proton pump inhibitor(PPI) based triple therapy, that combining PPI, clarithromycin, amoxicillin is widely accepted throughout the world, and shows high eradication rate which ranged about 80-90%. In Japan, one week triple therapy is recommended for the treatment of gastro-duodenal ulcer, though it is expected the improvement of recurrent peptic ulcer. In the present studies, the rate of clarithromycin resistant strains has been increased gradually, and this fact may lead to the development of failure of PPI based triple therapy. Another problem is suggested by several studies that gastro-esophageal reflux disease(GERD) may increase after successful eradication of H. pylori. Reflux esophagitis and Barrett's esophagus are recognized as precancerous lesion of esophageal adenocarcinoma, but the association of newly occurrence of GERD after H. pylori eradication and increase of esophageal adenocarcinoma is not clear. Merits and demerits of H. pylori eradication need to be observed carefully over a long term.     

Helicobacter pylori infection in patients with Brunner's gland adenoma

Histopathologic and clinical data strongly suggest a causal relation between Helicobacter pylori infection and gastritis, peptic ulcer disease, or both. However, little has been written about the potential association between H. pylori infection and Brunner's gland adenoma. Therefore, we carried out a prospective study to determine the presence of H. pylori infection among patients with Brunner's gland adenoma. From November 1996 till October 1999, 19100 patients who had undergone upper gastrointestinal endoscopy at two clinical centers in Zagreb, Croatia, were candidates for participation in the study. Brunner's gland adenoma was diagnosed on the basis of histologic samples taken from the polyp (four patients) or after the entire polyp was made available upon endoscopic removal (three patients). When all endoscopic examinations had been performed, biopsy samples were taken from the antrum and body of the stomach, so that gastritis could be classified and H. pylori determined by histology. Biopsy samples were also taken from the duodenal bulb to verify duodenitis. Two other samples were taken from the antrum for rapid urease test. The patients were considered positive for H. pylori when both histology and rapid urease test were positive. Brunner's gland adenoma was diagnosed in seven patients (five women and two men; median age, 49 yrs). Five (71%) patients with diagnosed Brunner's gland adenoma had concurrent H. pylori infection. Duodenitis associated with gastric metaplasia was observed in six patients. Complete eradication of H. pylori was achieved in only two patients. Symptoms disappeared or markedly diminished in all patients with significant improvement during therapy or immediately upon endoscopic removal of the polyp. Although limited by a very small number of patients, our results suggest that concurrent H. pylori infection is very common in patients with Brunner's gland adenoma. However, the role of H. pylori infection in the pathogenesis and development of Brunner's gland hyperplasia remains unclear.     

Helicobacter pylori infection in patients with selective immunoglobulin a deficiency

Selective immunoglobulin A (IgA) deficiency (IgAD) is the most common primary immunodeficiency in the western world. The aim of the study was to investigate the prevalence and clinical characteristics of Helicobacter pylori‐infected dyspeptic patients with IgAD. Case samples were drawn from all subjects ≥ 12 years of age (n = 104729) who had undergone serum total IgA measurements during 2004–14 for any reason at Leumit Healthcare Services (Israel) and had serum total IgA < 0·07 g/l. The control group was comprised of a random sample of remaining patients with a case–control ratio of 10 controls for each case. The dyspeptic diseases were identified and retrieved from Leumit Health Care Services electronic database using specific ICD‐9‐CM diagnostic codes. The case group included 347 subjects and the control group 3470 subjects. There were no significant differences in the prevalence of patients with dyspepsia [84 (24·2%) versus 821 (23·6%) for cases and controls, respectively]. Additionally, there was no difference in a proportion of dyspeptic H. pylori‐positive subjects [59 (17·1%) versus 524 (15·1%)] between the case and control groups. Only 59 (17%) among the 347 IgAD patients underwent gastroscopy. A significantly larger proportion of case subjects experienced several forms of gastritis [13 (61·9%) versus 38 (21·6%), P < 0·001), duodenal ulcers [seven (33·3%) versus 19 (10·8%); P = 0·01] and nodular lymphoid hyperplasia (NLH) [two (9·5%) versus none; P = 0·011]. IgAD is not associated with increased prevalence of H. pylori‐associated dyspepsia; nevertheless, H. pylori‐infected dyspeptic IgAD subjects experience more EGD‐proved gastritis, duodenal ulcers and NLH.     

Seroprevalence of Helicobacter pylori infection in patients with hepatitis B.

Helicobacter pylori infection has been investigated extensively in immunocompromised hosts, such as those with acquired immunodeficiency syndrome (AIDS) and organ transplant recipients. However, few reports on H. pylori prevalence in individuals with chronic HBV infection are available. The aim of this serological study is to investigate H. pylori prevalence in patients with hepatitis B. Ninety-six consecutive hospitalised patients with chronic hepatitis B were studied, together with 104 age-matched healthy individuals of similar socioeconomic status and with no evidence of hepatitis B virus infection or liver diseases. Serum samples from both groups were tested for specific IgG antibodies to H. pylori, using enzyme-linked immunosorbent assay (ELISA). Of the 96 patients with hepatitis B, 55 (57.3%) were positive for serum IgG anti-H. pylori, significantly greater than in the control group of 104, where 44 (42.3%) were positive (P < 0.05). In addition, the seroprevalence of H. pylori in the 45 patients who were positive for hepatitis B envelope antigen (HBeAg) and/or HBV-DNA was 75.6% (34), compared to 41.2% (21) in the 51 patients who were negative (P < 0.005). An increase in H. pylori prevalence is present in patients with chronic hepatitis B. Further study is needed to determine whether eradication of H. pylori will benefit these patients.     

Evaluation of Helicobacter pylori infection in patients with common migraine headache

Introduction

Migraine can cause headache in different communities so that 12-15% are suffering worldwide. Recently the relationship between infectious diseases such as Helicobacter pylori infection and migraine headache has been the focus of many studies. The current study was designed to evaluate IgG and IgM antibodies to H. pylori in patients suffering from migraine headaches.

Material and methods

Patients who had diagnostic criteria for migraine were chosen as cases compared to some healthy individuals as the control group amongst which immunoglobulin G (IgG), immunoglobulin M (IgM), age, job, gastro-intestinal (GI) disorders, history of migraine, special meals, medications, sleeping disorders, stress, environmental factors etc were analysed.

Results

The prevalence of disease was 38.6%. Household women had the highest prevalence (40%). Among them menstruation was related to high prevalence of migraine. 75.6% of patients had gastrointestinal disorders of which the gastric reflux was the most important sign (47.1%). The mean optical density (OD) value of IgG and IgM antibody to H. pylori was 60.08 ±7.7 and 32.1 ±8.7 for the case group, 21.82 ±6.2 and 17.6 ±9.4 for the control group, respectively.

Conclusions

There was a significant difference in mean OD value of both antibodies to H. pylori amongst the case and control groups. As a result, active H. pylori infection is strongly related to the outbreak and severity of migraine headaches, and H. pylori treatment reduces migraine headaches significantly. Hopefully, the definite treatment and eradication of this infection can cure or reduce the severity and course of migraine headaches significantly if not totally.     

细胞自噬与幽门螺杆菌感染

幽门螺杆菌是一种广泛定植于人胃黏膜的革兰阴性菌,它通过逃逸机体局部免疫杀灭而持续感染,最终导致胃上皮损伤,与多种胃部疾病相关.自噬是进化过程中保留的细胞机制,既能清除胞质内容物,又不影响细胞的生存.幽门螺杆菌能够入侵胃上皮细胞和某些免疫细胞,诱导自噬的发生,并在自噬体中自我复制后被清除,推测自噬可能在幽门螺杆菌感染中扮...     

Circulating antibodies to the 60-kD heat shock protein (hsp) family in patients with Helicobacter pylori infection

Whilst the mechanism by which Helicobacter pylori causes different gastroduodenal diseases is uncertain, strains producing the cytotoxin-associated protein (CagA) have greater pathogenicity. Hsps are immunogenic molecules induced by inflammatory mediators. The aim of this study was to assess pathogenicity of hsp antibodies in H. pylori-infected patients. ELISA techniques were used to assay sera of H. pylori-positive patients with gastritis, gastric atrophy, duodenal or gastric ulcer, and H. pylori-negative controls, for antibodies to CagA and to human, mycobacterial, and in 20 sera, H. pylori (hspB) 60-kD hsp. IgA antibodies to mycobacterial hsp60 in atrophy patients were elevated compared with patients with gastritis (P < 0.05) and with H. pylori-negative controls (P < 0.0005). IgA antibodies to human hsp60 in gastric atrophy patients were elevated compared with H. pylori-negative controls (P < 0.05). Patients with atrophy (P < 0.0005) and gastritis (P < 0.05) who were CagA-positive had raised titres of anti-mycobacterial hsp60 IgA antibodies compared with controls. IgA antibody levels to hspB were positively correlated with those to mycobacterial hsp60 (mhsp60) (P < 0.05) and human hsp60 (hhsp60) (P < 0.005). IgA antibodies to hsp60 are associated with gastroduodenal disease, particularly gastric atrophy, in H. pylori-infected patients. Increased humoral responses to hsp60 could either contribute to gastric atrophy or result from greater gastric mucosal damage induced by CagA-positive strains of H. pylori.