幽门螺杆菌感染和胃泌素与结直肠腺瘤性息肉的相关性研究

目的探讨幽门螺杆菌(Helicobacter pylori,H.pylori)感染和血清胃泌素水平与结直肠腺瘤性息肉的相关性。方法经胃、肠镜检查,选取120例结直肠腺瘤性息肉患者为研究组,需描述息肉的部位、大小、数目、黏膜情况、山田分型和组织病理分型。另选取120例结肠无明显异常者为对照组,所有入选者均完成13C-尿素呼气试验和胃泌素17(gastrin 17,G17)检测。结果研究组的年龄、中老年患者比例(≥40岁)和H.pylori阳性率均高于对照组,差异有统计学意义(P0.05);左半结肠、多发性和大息肉(≥10 mm)的H.pylori阳性率明显高于右半结肠、单发性和小息肉(10 mm)(P0.05),而山田分型和病理分型亚组比较,差异无统计学意义(P0.05)。研究组血清G17水平高于对照组,二组中H.pylori阳性者G17水平也分别高于H.pylori阴性者,差异均有统计学意义(P0.05)。结论 H.pylori感染可能通过刺激胃泌素分泌影响结直肠腺瘤性息肉的发生、发展,对于H.pylori阳性,尤其中老年患者,应尽早完善结肠镜检查,降低结直肠癌(colorectal cancer,CRC)的潜在风险。     

幽门螺杆菌与结直肠腺瘤发病关系的Meta分析

目的探讨结直肠腺瘤与幽门螺杆菌(Helicobacter pylori,H. pylori)感染之间的关系。方法选择徐州医科大学附属医院住院同时完成H. pylori检测和结直肠镜检查的患者354例,分为腺瘤性息肉组(n=146)、增生性息肉组(n=100)、对照组(n=108),分析H. pylori感染与结直肠腺瘤之间的关系。并回顾收集到的关于H. pylori感染与结直肠腺瘤发病关系的研究进行Meta分析。结果腺瘤组与增生组,增生组与对照组之间H. pylori感染率差异无统计学意义(P 0. 05),腺瘤组与对照组组之间H. pylori感染率差异有统计学意义(P 0. 05)。Meta分析纳入31项研究,腺瘤组8 645例,对照组16 305例,腺瘤组H. pylori感染率明显高于对照组(P 0. 05)。结论 H. pylori感染会增加结直肠腺瘤的发病率。     

代谢综合征对结直肠管状绒毛状腺瘤的影响因素分析

目的分析结直肠管状绒毛状腺瘤与代谢综合征的关系。 方法收集2017年6月至2020年12月南方医科大学附属惠阳医院经手术病理确诊的271例患者。其中管状腺瘤患者203例，管状绒毛状腺瘤患者68例。比较结直肠管状腺瘤与管状绒毛状腺瘤患者纤维结肠内镜检查的基本情况，结直肠息肉一般特征、数目、病理，以及代谢综合征相关指标水平等。采用Logistic多因素回归分析山田分型、最大息肉直径、代谢综合征相关指标与结直肠管状绒毛状腺瘤的关系。 结果累计息肉数目最多部位、最大息肉好发部位、病理为管状绒毛状腺瘤/管状腺瘤好发部位均为乙状结肠。结直肠管状腺瘤与管状绒毛状腺瘤患者山田分型、最大息肉直径、血清甘油三酯水平差异均有统计学意义（P均<0.01），而高血压、脂肪肝、空腹血糖受损或糖尿病情况及总胆固醇水平、血清尿酸水平、癌胚抗原水平差异均无统计学意义（P>0.05）。Logistic多因素回归分析结果显示，山田分型及最大息肉直径与结直肠管状绒毛状腺瘤有关联[Wald χ²=5.756，Exp（B）=2.494，P=0.016；Wald χ²=23.173，Exp（B）=12.842，P<0.001]，而血清甘油三酯水平与结直肠管状绒毛状腺瘤无关联。 结论与结直肠管状腺瘤患者相比，代谢综合征与结直肠管状绒毛状腺瘤发病并无直接关联，但息肉直径大小及山田分型与结直肠管状绒毛状腺瘤发病有关联。     

小肠细菌过生长及三酰甘油与老年人结直肠息肉临床关系的研究

目的 探讨小肠细菌过生长（small intestinal bacterial overgrowth,SIBO）及三酰甘油（triglyceride,TG）与老年人结直肠息肉的关系及其临床意义。方法 回顾性分析2018年10月—2021年1月在河北省沧州市中心医院同时行结肠镜及甲烷氢乳果糖呼气试验（lactulose breath test,LBT）检查的156例年龄≥65岁的老年结直肠息肉患者,根据结直肠息肉个数分为：单发结直肠息肉组、多发结直肠息肉组;根据结直肠息肉病理分型分为：炎性息肉组、腺瘤性息肉组;同时选取40例老年健康志愿者为健康对照组。分析比较各组的SIBO阳性率及空腹血总胆固醇（total cholesterol,TC）、TG水平。结果 结直肠息肉组的TC、TG水平及SIBO阳性率高于健康对照组（P=0.035,P=0.003,P=0.001）,三者在单发结直肠息肉组与多发结直肠息肉组间及炎性息肉组与腺瘤性息肉组间差异无统计学意义（P> 0.05）。SIBO阳性结直肠息肉患者的TC、TG水平高于SIBO阴性结直肠息肉患者（P=0.028,P=0.001）。高TG、...     

老年胆囊切除患者结直肠腺瘤临床特点分析

目的了解老年胆囊切除患者结直肠腺瘤的临床特点,为老年结直肠癌的防治提供参考。方法纳入经肠镜检查发现息肉并行病理学检查提示为结直肠腺瘤的老年患者共1 272例,除外恶性肿瘤、家族性腺瘤性息肉病、炎症性肠病。根据既往有无行胆囊切除手术分为胆囊切除组和对照组,比较两组患者结直肠腺瘤的数量、大小、发生部位、病理类型,并比较胆囊切除时间不同亚组的结直肠腺瘤的特征。结果胆囊切除组女性患者比例明显高于对照组(P0.05);吸烟患者比例明显低于对照组(P0.05);腺瘤个数多于对照组(P0.05);绒毛状腺瘤比例高于对照组(P0.05)。恶变高风险息肉在胆囊切除时间不同的两个亚组中的比例差异无统计学意义(P0.05)。结论尽管与胆囊切除时间长短无关,老年胆囊切除患者结直肠腺瘤具有更高的恶变风险。     

结直肠息肉与幽门螺杆菌感染及血脂水平的相关性研究

目的 探讨结直肠息肉发生与幽门螺杆菌(Helicobacter pylori,H.pylori)感染及血脂水平升高的相关性,为通过检测H.pylori和血脂水平对结直肠息肉的早期诊断提供理论依据。方法 选取广州医科大学附属第三医院2020年1月1日至2020年6月30日行肠镜检查的患者250例,根据检查结果,185例为观察组(结直肠息肉),65例为对照组(结直肠无明显异常),所有患者均完成呼气试验及血脂水平检测。回顾性分析结直肠息肉的大小、数量、病理分型、山田分型、发生部位与H.pylori感染及血脂水平异常的关系。结果 观察组H.pylori感染率高于对照组(P<0.01)。结直肠息肉的大小(≥10 mm)、数量(多发)、病理分型(腺瘤性)与H.pylori感染呈正相关(P<0.05)。结直肠息肉山田分型及发生部位与H.pylori感染无相关(P>0.05)。观察组患者的LDL-C、TC、Apo B、Lp(a)水平均高于对照组(P<0.05),其中观察组H.pylori阳性患者的LDL-C、TC、Apo B水平均高于H.pylori阴性患者(P<0.05...     

幽门螺杆菌感染与结直肠息肉发生的关系

目的探索幽门螺杆菌（Hp）感染与结直肠息肉发生的相关性,同时分析Hp感染与结直肠息肉临床特征的关系。方法从瑞金医院体检人群中选取接受胃肠镜检查者,随机选出120例结直肠息肉检出患者作为病例组,另150例结直肠无明显异常者列为对照,所有入选人群均经13c呼气试验检查判断有无Hp感染。结果结直肠息肉组Hp阳性率显著高于非息肉组（85％比74％,x2=4．28,P=0．037）,当考虑Hp感染与结直肠息肉临床特征的关系时,发现在直肠、乙状结肠以及降结肠息肉患者中,Hp阳性检出率较Hp阴性组明显增高,差异有统计学意义（P=0．038）。且Hp阳性组与Hp阴性组相比,多发性息肉所占比例较单发高,差异有统计学意义（P=0．004）。结论H声感染可增加结直肠息肉的发生风险,其具体致病机制有待进一步研究。     

幽门螺杆菌与结肠腺瘤相关性的研究

目的探讨幽门螺杆菌感染（Helicobacter pylori, H.pylori）和结肠腺瘤的关系。 方法选取2014年1月至2015年5月就诊于我院有消化道症状或无症状体检患者,经结肠镜检查及病理证实为结肠腺瘤患者200例,无结肠腺瘤患者200例作为对照组,两组患者均行¹³C尿素呼气试验检查是否存在幽门螺杆菌感染,统计结果采用卡方检验,P<0.05时认为差异有统计学意义。 结果H.pylori感染合并结肠腺瘤的患者比例少于对照组,但两组数据比较差异无统计学意义。 结论H.pylori感染与结肠腺瘤的发生无明显相关性。     

幽门螺杆菌感染与大肠息肉发病关系探讨

[目的]初步探讨幽门螺杆菌(Helicobacter pylori,Hp)感染与大肠息肉发病关系。[方法]收集行结肠镜检查和血清学Hp检查1 605例患者临床资料,息肉组842例,结肠镜检查正常为对照组763例,比较2组Hp感染率情况。[结果]息肉组及其管状腺瘤息肉者、管状绒毛状腺瘤息肉者Hp感染率均高于对照组,差异有统计学意义(P0.05～0.01),增生性息肉者Hp感染率高于对照组,但差异无统计学意义(P0.05)。女性息肉组Hp感染率高于对照组,差异有统计学意义(P0.05),增生性息肉者Hp感染率高于对照组,差异无统计学意义(P0.05);男性增生性息肉、腺瘤性息肉者Hp感染率高于对照组,差异无统计学意义(P0.05)。直径1cm、直径≥1cm息肉组Hp阳性率高于对照组,单发息肉组、多发息肉组Hp阳性率高于对照组,均差异有统计学意义(P0.05)。[结论]大肠息肉者具高Hp感染率,尤其女性明显;息肉大小、数目与Hp感染无关。     

高脂血症与结直肠腺瘤的关系

目的探讨高脂血症与结直肠腺瘤的关系。方法检测141例结直肠腺瘤患者和120例对照组患者的血脂,分析结直肠腺瘤组与对照组之间、不同病理类型结直肠腺瘤组中血脂的情况。结果 141例结直肠腺瘤组中有高脂血症59例(41.8%),120例对照组中有高脂血症20例(16.7%),结直肠腺瘤组的高脂血症发生率显著高于对照组(P0.05)。不同病理类型结直肠腺瘤组中,高脂血症者分别为39例(41.9%)、13例(40.6%)、7例(43.8%),三者比较,差异无统计学意义(P0.05)。结论高脂血症与结直肠腺瘤的发生相关。     

结直肠息肉、结直肠癌的特点及与幽门螺杆菌感染相关性的研究

目的 探讨结直肠息肉、结直肠癌临床与病理的特点及其与幽门螺旋杆菌(Helicobacter pylori,H.pylori)感染的相关性.方法 收集安徽医科大学第二附属医院2018年7月至2020年9月同时行肠镜及幽门螺旋杆菌血清学抗体检测的患者资料共460例,并分为结直肠息肉组、结直肠癌组、正常对照组,回顾性分析结直...     

Helicobacter pylori and the risk of colonic adenomas. Colorectal Adenoma Study Group.

AIMS: Previous studies have found a positive association between Helicobacter pylori infection and colorectal adenomas. The aim of the present study was to examine this association while taking possible confounding factors into account. METHODS: 98 serum samples were available from 182 patients with colorectal adenomas who entered a case-control study of colorectal adenomas and diet. The H. pylori status in patients was compared with a hospital control group and a population control group. RESULTS: H. pylori IgG antibodies were more common in colorectal polyp patients compared with either control group, the prevalence being 79% in cases compared with 62% in both control groups. The corresponding RR was 1.4 (0.76-2.6) compared with hospital controls and 2.1 (1.1-3.9) compared with population controls. After adjusting for possible confounding variables the association between H. pylori status and adenoma risk was even more marked. There was an RR of 1.6 (0.80-3.4) compared with hospital controls and an RR of 2.6 (1.3-5.4) compared with population controls, the latter association being statistically significant. CONCLUSION: These findings suggest a statistically significant association between H. pylori infection and colorectal polyps. A possible mechanism might be increased gastrin levels in H. pylori-infected subjects which exhibit a trophic effect on colonic mucosa.     

Gastric dysplasia may be an independent risk factor of an advanced colorectal neoplasm

AIM: To evaluate the relationship between gastric dysplasia and Helicobacter pylori ( H pylori) and the occurrence of colorectal adenoma, and to define the necessity for colonoscopy in patients with gastric dysplasia or H pylori infection.METHODS: From May 2005 to February 2008, 133 patients with established gastric dysplasia by gastroduodenoscopy (EGD) were additionally investigated by colonoscopy. The authors compared results with those of 213 subjects who underwent both EGD and colonoscopy during the same period at the author's Health Promotion Center as a control group. H pylori infection was evaluated in both the gastric dysplasia and control groups.RESULTS: The mean age of all 346 study subjects was 54.1 ± 10.5 years, and there were 258 (73%) men and 87 (27%) women. No significant difference was found between the H pylori positive and negative subjects in terms of the prevalence of colorectal adenoma and advanced colorectal adenoma ( P = 0.261). Patients with gastric dysplasia showed no elevated risk of colorectal adenoma (OR = 0.910, 95% CI: 0.5871.411,P = 0.738),but had a significantly higher risk of having advanced colorectal adenoma (OR = 3.382, 95% CI: 1.7006.342,P = 0.000).CONCLUSION: The study emphasizes the need for colon surveillance in patients with gastric dysplasia,regardless of H pylori infection.     

幽门螺杆菌感染与肠易激综合征关系研究

目的研究幽门螺杆菌(H.pylori)感染与肠易激综合征(IBS)之间的关系。方法随机选取肠易激综合征患者40例为实验组,另选取40例正常健康者为对照组,应用13C尿素呼气试验及快速尿素酶法分别测定二者的H.pylori感染率。并根据检测结果将26例H.pylori阳性的IBS患者随机分为观察组(13例)和对照组(13例),观察组加用根除H.pylori药物治疗2周,观察其疗效。结果 IBS患者中的H.pylori感染率(65.00%)明显高于对照组(42.50%),二者相比差异有统计学意义(P<0.05)。H.pylori阳性的IBS患者,观察组治疗有效率(92.31%)明显高于对照组(38.46%),差异有统计学意义(P<0.05)。结论 H.pylori感染与肠易激综合征之间有一定关系,根除H.pylori可能在IBS的治疗中起一定作用。     

Association of Helicobacter pylori enrichment in colorectal adenoma tissue on clinical and pathological features of adenoma

ObjectiveTo investigate the enrichment of Helicobacter pylori (Hp) in adenoma tissue of patients with colorectal adenoma, and analyze the correlation between the enrichment and the clinical and pathological characteristics of colorectal adenoma.MethodsThe data of 1,622 patients undergoing gastrointestinal endoscopy in the Endoscopy Center of Wenzhou Integrated Traditional Chinese and Western Medicine Hospital affiliated to Zhejiang University of Traditional Chinese Medicine from January 2019 to June 2021 were retrospectively collected. The general data, gastric Hp infection, clinical and pathological features of colorectal adenoma, methylene blue staining of adenoma Hp, immunohistochemistry of adenoma Hp and immunofluorescence staining of adenoma TLR5 protein. were compared between the colorectal adenoma group (743 cases) and the control group (879 cases).ResultsThere were 361 gastric Hp positive cases in the colorectal adenoma group, with a positive rate of 48.59%, and 331 gastric Hp positive cases in the control group, with a positive rate of 37.66%, and the difference was statistically significant (P < 0.001). Gastric Hp infection significantly correlates with the Hp enrichment in colorectal adenomas (OR: 28.449; 95%CI: 18.188-44.500; P < 0.001). Moreover, we found that Hp enrichment in colorectal adenomas was correlated with the diameter, pathological type, and malignancy of adenoma (OR: 3.536; 3.652; 2.833; all P < 0.001). Expression TLR5 protein was also increased in Hp-enriched adenoma tissue.ConclusionThere is a correlation between gastric Hp infection and intestinal Hp enrichment. The intestinal Hp enrichment significantly correlates with the clinical and pathological characteristics of colorectal adenomas, and its tumor-promoting effect may be related to the up-regulation of mucosal TLR5 expression.     

胃食管反流病与幽门螺杆菌及胃排空关系的研究

目的探讨幽门螺杆菌(H.pylori)与胃食管反流病(GERD)的关系,以及H.pylori对GERD患者胃动力的影响。方法按中华医学会的GERD诊断标准,确诊GERD患者200例,进行胃镜、胃排空时间及H.pylori检查,依据洛杉矶分级将反流性食管炎(RE)分为A、B、C、D四级,200例无消化道症状的健康体检者作为对照组,进行H.pylori检查。结果 GERD组的感染率明显低于对照组(P<0.05),反流性食管炎(RE)的炎症程度与H.pylori的感染率呈负相关,GERD患者中H.pylori阳性组和H.pylori阴性组间胃排空情况无统计学差异(P>0.05)。结论 H.pylori可能对GERD有潜在的保护作用;RE炎症程度越重,H.pylori感染率越低;H.pylori不影响GERD患者的胃动力。     

Correlation between Helicobacter pylori-associated gastric diseases and colorectal neoplasia

AIM: To explore the correlation between Helicobacter pylori(H. pylori)-associated gastric diseases and colorectal neoplasia.METHODS: Patients included in this study underwent a colonoscopy and esophago-gastro-duodenoscopy(EGD) along with histopathological measurement between March 2012 and March 2015 at Qi-Lu Hospital of Shandong University, who also had results of H. pylori detection. A total of 233 cases were selected. Demographic data, H. pylori infection status(including results of rapid urease tests and gastric mucosa pathological examinations) and histopathological examination results of gastric and colorectal mucosa were gathered and analyzed. The statistical analysis focused on the prevalence of colorectal neoplasms among patients with various histopathological categories of the stomach. ORs and their 95%CI were calculated to describe the strengths of the associations.RESULTS: The incidence rates of colorectal adenoma without high-grade intraepithelial neoplasia(HGIEN)(OR = 2.400, 95%CI: 0.969-5.941), adenoma with HGIEN(5.333, 1.025-27.758) and adenocarcinoma(1.455, 0.382-5.543) were all higher for patients with H. pylori-associated gastritis than for those in the control group. The incidence rate of colorectal adenoma with HGIEN(3.218, 0.767-13.509) was higher in patients with intestinal metaplasia than in the control group, while the incidence rates of adenoma without HGIEN(0.874, 0.414-1.845) and adenocarcinoma(0.376, 0.096-1.470) were lower in the intestinal metaplasia group than in the control group. The incidence rate of colorectal adenoma without HGIEN(3.111, 1.248-7.753) was significantly higher in the gastric intraepithelial neoplasia group than in the control group, while the rates of adenoma with HGIEN(1.481, 0.138-15.941) and adenocarcinoma(2.020, 0.561-7.272) were higher in the gastric intraepithelial neoplasia group. Incidence rates of colorectal adenoma without HGIEN(1.067, 0.264-4.314), adenoma with HGIEN(2.667, 0.231-30.800) and adenocarcinoma(2.182, 0.450-10.585) were all higher in the gastric adenocarcinoma group than in the control group.CONCLUSION: H. pylori infection as well as H. pylori-associated gastric diseases are risk factors for colorectal neoplasia.     

胃食管反流病与幽门螺杆菌感染的关系探讨

目的探讨胃食管反流病与幽门螺杆菌感染之间的相关性。方法将经过电子胃镜确诊的GERD患者120例及对照组轻度慢性浅表性胃炎患者120例予血清幽门螺杆菌抗体检测和14C呼气试验法进行H.pylori检测,对比两组H.pylori感染情况;将90例反流性食管炎患者分为LA-A、B组及LA-C、D组,对比两组H.pylori感染情况;将120例GERD患者分为轻度症状组、中度症状组、重度症状组及极重度症状组,比较组间H.pylori感染情况。结果 GERD组H.pylori感染的阳性率(39.17%)低于对照组H.pylori感染的阳性率(62.50%),差异有统计学意义(P<0.05)。LA-A、B组H.pylori感染的阳性率(60.87%)高于LA-C、D组H.pylori感染的阳性率(29.55%),差异有统计学意义(P<0.05)。轻度症状组、中度症状组、重度症状组及极重度症状组H.pylori感染的阳性率分别是40.00%、41.67%、40.63%、31.82%。结论幽门螺杆菌感染是反流性食管炎的保护因素,幽门螺杆菌感染与GERD症状的发生无相关性。     

大肠小扁平腺瘤、息肉样腺瘤p53、p21表达的研究

目的:观察大肠小扁平腺瘤p53、p21基因的表达,探讨小扁平腺瘤与息肉样腺瘤生物学行为的不同及其与大肠癌的关系.方法:利用免疫组化法研究50例小扁平腺瘤(A组)和30例息肉样腺瘤(B组)以及20例正常大肠黏膜(C组)的p53、P21基因表达情况.结果:p53、p21 在A、B、C 三组中阳性率分别为58%、56%;33.3%、36.7%;5%、10%.P53阳性率三组间差异有显著性(P＜0.05).p21阳性率:A、B组分别与C组有差异显著性(P＜0.05);A组高于B组,但卡方检验P＞0.05,无统汁学差异;A组进一步与B组中直径＜1.0cm的腺瘤的p21阳性率(30%)比较,差异有显著性(P＜0.05).结论:大肠小扁平腺瘤p53、p21基因的异常表达提示小扁平腺瘤的生物学行为与息肉样腺瘤有差别,可能更易于恶变.     

Helicobacter pylori infection in patients with autoimmune thrombocytopenic purpura

AIM: To compare the prevalence of Helicobacter pylori(Hpylori) infection in autoimmune thrombocytopenic purpura (AITP) patients with that of nonthrombocytopenic controls,and to evaluate the efficacy of the treatment in Hpylori(+)and Hpylori(-) AITP patients.METHODS: The prevalence of gastric Hpyloriinfection in 38 adult AITP patients (29 female and 9 male; median age 27 years; range 18-39 years) who consecutively admitted to our clinic was investagated.RESULTS: Hpyloriinfection was found in 26 of 38 AITP patients (68.5%). Hpyloriinfection was found in 15 of 23 control subjects (65.2%). The difference in Hpyloriinfection between the 2 groups was not significant. Thrombocyte count of Hpylori-positive AITP patients was significantly lower than that of Hpylori-negative AITP patients (P＜0.05).Thrombocyte recovery of Hpylori-positive group was less than that of Hpylori-negative group (P＜0.05).CONCLUSION: Hpyloriinfection should be considerecd in the treatment of AITP patients with Hpyloriinfection.