高海拔地区军人胃肠疾病与幽门螺杆菌感染的相关性研究

目的探讨高海拔地区军人胃、十二指肠等胃肠疾病的高发病率与幽门螺杆菌(H.pylori)感染的相关性。方法对2011年长期驻扎在西藏那曲地区申扎县军人,经申扎县人民医院门诊并确定有胃肠疾病的412例患者,行胃镜及胃黏膜病理组织学检查,采用美蓝染色检测H.pylori感染情况,观察胃黏膜组织炎症活动程度。结果 412例患者H.pylori总感染率为71.6%。胃溃疡、十二指肠溃疡、糜烂性胃炎患者H.pylori感染率分别为81.5%、93.9%、89.1%,萎缩性胃炎、肠化、异型增生患者H.pylori感染率分别为63.8%、67.4%、73.3%,明显高于浅表性胃炎患者的49.1%(P<0.05)。士兵入伍后的前3年,随军龄的增加,H.pylori感染率逐渐增加(P<0.05),3年以上军龄者H.pylori感染率无明显差异。所有慢性胃炎患者胃黏膜组织炎症活动从轻度(+)→中度(++)→重度(+++),其H.pylori感染率逐级增加,分别为42.7%、56.2%、76.2%,差异有统计学意义(P<0.05)。结论高海拔地区的军人胃、十二指肠等胃肠疾病患者H.pylori感染率高,军人的军营生活特点可能促使H.pylori感染。     

非糜烂性胃食管反流病与幽门螺杆菌感染的相关性研究

目的探讨非糜烂性胃食管反流病(non-erosive gastroesophageal reflux disease,NERD)与幽门螺杆菌(Helicobacter pylori,H.pylori)感染的关系。方法将确诊为军人NERD患者156例(A组)、军人慢性浅表性胃炎患者120例(B组)和军人十二指肠球部溃疡患者60例(C组),予活检胃窦组织快速尿素酶法及14C呼气试验法进行H.pylori检测;比较A组与B组、C组H.pylori感染情况。结果 A组H.pylori感染率12.82%,B组H.pylori感染率68.33%,C组H.pylori感染率85.00%,A组感染率明显低于B组、C组,差异均有显著统计学意义(P0.01)。结论 NERD发生时,H.pylori感染几率明显减小。     

唾液、牙斑与胃黏膜幽门螺杆菌感染关系的研究

背景幽门螺杆菌(H.pyloori)在人群中感染率高,但其传播途径仍不清楚.目前有关口腔中H.pylori感染与胃黏膜H.plori感染关系的研究不多.目的了解口腔中的H.pylori感染状况及其与胃黏膜H.pylori感染的关系.方法应用聚合酶链反应(PCR)技术同时检测60例非萎缩性胃炎患者唾液、牙斑和胃黏膜中的H.pylori.结果47例胃黏膜H.pylori阳性的胃炎患者中有31例(66.0%)唾液中检出H.pylori,17例(36.2%)牙斑中检出H.pylori;而13例胃黏膜H.pylori阴性的胃炎患者中仍有1例(7.7%)唾液中检出H.pylori,2例(15.4%)牙斑中检出H.pylori.胃黏膜H.pylori阳性与阴性胃炎患者唾液和牙斑中的H.pylori检出率有显著差异(P＜0.01).结论口腔中的H.pylori与胃黏膜中的H.pylori之间可能存在一定的病因学联系.     

胃复春联合四联疗法治疗H.pylori相关性慢性非萎缩性胃炎临床疗效观察

目的观察胃复春联合四联疗法对幽门螺杆菌(Helicobacter pylori,H.pylori)相关性慢性非萎缩性胃炎的治疗效果.目的选取196例H.pylori相关性慢性非萎缩性胃炎患者,随机分为治疗组(胃复春联合四联疗法)99例和对照组(四联疗法)97例,比较2组患者治疗后的临床症状和胃镜改善情况以及H.pylori根除率.结果治疗组患者症状总有效率、胃镜总有效率和H.pylori根除率均高于对照组(93.9%vs85.6%,91.9%vs 84.5%,92.9%vs 83.5%),疗效明显优于对照组,差异具有统计学意义(P0.05).结论胃复春联合四联疗法治疗H.pylori相关性慢性非萎缩性胃炎疗效优于单纯四联疗法,可提高H.pylori根除率,值得在临床推广使用.     

青岛地区胃黏膜病变患者幽门螺杆菌及其相关抗体的分析

目的探讨幽门螺杆菌(H.pylori)、H.pylori相关抗体与不同胃黏膜疾病的关系及其临床意义。方法对2015年6月-2016年5月青岛大学附属医院收治的294例符合条件的胃黏膜疾病患者进行研究。其中慢性非萎缩性胃炎56例,慢性萎缩性胃炎68例,胃溃疡64例,胃黏膜上皮内瘤变54例,胃癌52例。所有患者通过胃镜下表现及病理结果确定疾病分组,分别行血清H.pylori抗体测定,确定H.pylori感染率、H.pylori现症感染率(即组织染色H.pylori阳性率)、H.pylori分型,并进行统计学分析。结果慢性非萎缩性胃炎、慢性萎缩性胃炎、胃溃疡、上皮内瘤变、胃癌患者的H.pylori感染率分别为85.7%、79.4%、93.8%、92.6%、96.2%。现症感染率分别为75.0%、70.6%、90.6%、85.2%、78.8%。胃癌患者Cag A抗体和Vac A抗体的阳性率分别为86.5%、84.6%,显著高于其他胃黏膜病变患者。后者各组间的Cag A抗体阳性率(58.9%~71.9%)和Vac A抗体阳性率(57.1%~68.8%)差异无统计学意义(P0.05)。胃溃疡组的Ure A抗体和Ure B抗体阳性率最高(90.6%、93.8%),与慢性胃炎组比较(66.9%、67.7%),差异有统计学意义(P0.05),但与胃癌、上皮内瘤变组比较,差异无统计学意义(P0.05)。在H.pylori感染的262例患者中,Ⅰ型菌株183例(69.8%),Ⅱ型菌株50例(19.1%),中间型菌株29例(11.1%)。胃癌组Ⅱ型所占比例(2.0%)显著低于其他各组(20.0%~29.2%);Ⅰ型及中间型所占比例在各组患者中比较,差异无统计学意义(P0.05)。结论 H.pylori与胃黏膜病变密切相关,随着胃黏膜病变的加重,H.pylori感染率及毒力呈上升趋势。H.pylori抗体测定对预测胃癌发生的风险具有重要意义,其临床价值高于H.pylori组织染色检测结果。     

反流性食管炎与幽门螺杆菌感染的关系

目的:研究反流性食管炎(reflux esophagitis,RE)患者幽门螺杆菌(H pylori)感染率,感染程度与定植部位及胃炎的活动度,并对比H pylori阳性与阴性的RE患者食管炎症的严重程度.方法:选取从2007-01/03在我科行胃镜检查证实的RE患者89例,按年龄,性别进行配对的方式随机抽取无反流对照组89例,对比两组H pylori感染率,感染部位,感染程度的差异,并比较RE组中H ylori阳性与阴性患者食管炎症的严重程度.结果:RE组与对照组H pylori感染率无统计学差异(P=0.137),但RE组H pylori感染程度较对照组轻(P胃体=0.024,P胃窦=0.000),且RE组胃体炎症严重程度较对照组轻(P=0.001);H pylori阳性与阴性的RE患者发生洛杉矶(LA)C级分别占8.3%和1 8.5%,D级分别占4.2%和12.3%,但食管炎症的轻重程度无显著性差异(P=0.353).结论:H pylori的感染程度及胃体胃炎的活动性与RE的形成有负相关性.     

H pylori感染及根除对慢性糜烂性胃炎患者IL-18水平的影响

目的:探讨H pylori感染及根除对慢性糜烂性胃炎患者IL-18水平的影响,同时检测抗H pylori治疗前后抗体水平的变化.方法:60例上消化道患者分两组,慢性糜烂性胃炎组(实验组)40例,慢性浅表性胃炎组(对照组)20例.实验组H pylori阳性者予口服洛赛克20 mg和克拉霉素500 mg及阿莫西林1000 mg,1 wk后症状缓解者,开始口服洛赛克20 mg/d至4 wk实验结束,对照组仅口服洛赛克抗H pylori治疗,1 mo后复查~(13)C呼气实验和胃镜.H pylori免疫印迹法进行蛋白抗体分型,同时ELISA法检测H pylori-IgG,IL-18水平.结果:治疗前H pylori阳性者实验组血清IL-18水平高于对照组(267.18±148.23 ng/L vs 119.31±45.34 ng/L:P<0.05).抗H pylori治疗后慢性糜烂性胃炎患者的IL-18,抗体水平均有明显下降(267.18±148.23 ng/L vs 93.82±22.15 ng/L;31.36±23.26 kU/L vs 21.00±9.47 kU/L;P<0.05).H pylori感染类型及糜烂的严重程度与IL-18水平无明显的相关性.结论:抗H pylori治疗后IL-18水平的下降在慢性糜烂性胃炎糜烂的治疗过程中发挥重要作用.     

非酒精性脂肪性肝病与幽门螺杆菌感染的相关性

目的探讨非酒精性脂肪性肝病(NAFLD)与幽门螺杆菌(H.pylori)感染之间的关系。方法采用横断面研究方法,分析2011年于北京医院体检中心进行健康体检者中体检数据完整、进行13C-尿素呼气试验检测H.pylori及腹部超声检查的受试者14 373人(年龄≥18岁)的体检数据。应用非条件Logistic回归分析H.pylori感染状态与NAFLD的关系。结果 NAFLD及H.pylori感染检出率均在50~59岁年龄段最高,分别达46.27%和32.38%。NAFLD及H.pylori感染检出率随年龄变化趋势相同。NAFLD患者中H.pylori阳性者较H.pylori阴性者体质量指数(BMI)高、甘油三酯(TG)高,而高密度脂蛋白胆固醇(HDL-C)低(P0.05),肝功指标、血糖、尿酸无显著差异(P0.05)。H.pylori感染状态与NAFLD呈正相关(OR=1.265,95%CI:1.116~1.403)。结论H.pylori感染与NAFLD呈正相关,H.pylori感染可能是NAFLD发生的危险因素。     

三联疗法对非糜烂性反流病合并H pylori感染患者预后的影响

目的：探讨幽门螺杆菌(H pylori)根除对非糜烂性反流病(non-erosive reflux diseage,NERD)合并H pylori感染患者疗效及预后．方法：120例非糜烂性反流病合并H pylori感染患者随机分为：对照组60例,仅口服洛赛克(20 mg,2次/d)1 wk；三联疗法组60例：口服洛赛克(20 mg)和克拉霉素(500 mg)及阿莫西林(500 mg),均每天2次,连续1 wk,1 wk后非糜烂性症状缓解患者,开始口服洛赛克20 mg/d的维持治疗阶段至3 wk：试验结束后6 mo均行胃镜复查及~(13)C呼气试验．结果：试验结束后三联疗法组57例患者H pylori阴性(95．0%),对照组5例转阴(8．3%),两组H pylori根除率差异显著(P＜0．01)；对照组患者残胃萎缩及残胃肠化较H pylori根除组明显增多(P＜0．05),三联疗法但对反流症状烧灼感及进食后梗阻或异物感的改善不明显(P＞0．05)结论：三联疗法根除H pylori后对非糜烂性反流病合并H pylori感染患者的胃窦部的肠化生及不典型增生有防治疗效,但对反流症状烧灼感及进食后梗阻或异物感的改善不明显．     

幽门螺杆菌感染与胃黏膜改变及代谢综合征的关系

目的探讨无症状体检人群幽门螺杆菌(Helicobacter pylori,H.pylori)感染与代谢综合征(metabolic syndrome,MS)及胃十二指肠黏膜改变的关系。方法采用回顾性研究方法,选取2017年10月至2018年10月在徐州医科大学附属医院体检中心同时进行包括~(14)C尿素呼气试验、生化指标、空腹血糖(FBG)及收缩压(SBP)/舒张压(DBP)和体质量指数(BMI)等一般资料及病史完整者7 527例,其中同时完善胃镜检查者1 241例。根据~(14)C尿素呼气试验结果分为H.pylori阳性组和H.pylori阴性组。比较两组一般资料、代谢指标、MS患病率及胃炎、胃炎伴糜烂、胃溃疡、十二指肠溃疡、胃息肉患病率。将MS患者分为H.pylori阳性组与H.pylori阴性组,比较两组一般资料。比较不同年龄段H.pylori感染率与MS患病率的关系。结果 H.pylori感染的发生率为42.75%,MS的患病率为20.99%。H.pylori阳性组与H.pylori阴性组比较,MS患病率、胃溃疡患病率、十二指肠溃疡患病率、BMI、SBP、总胆固醇(CHOL)水平、甘油三脂(TG)水平明显升高(P0.05)。MS患者中H.pylori阳性组的BMI、DBP、CHOL水平显著升高。随着年龄增长,MS的患病率逐渐升高,75岁以上人群MS患病率最高(37.56%),H.pylori感染阳性率最高为46～60岁人群(43.90%)。16～30岁人群:H.pylori阳性组DBP、FBG水平较H.pylori阴性组高,HDL-C水平较H.pylori阴性组低;31～45岁人群:H.pylori阳性组BMI、DBP、TG水平较H.pylori阴性组高;46～60岁人群:H.pylori阳性组BMI、DBP、SBP、CHOL水平较H.pylori阴性组高;61～75岁人群:H.pylori阳性组DBP水平较H.pylori阴性组高;对于75岁以上人群H.pylori阳性组与阴性组代谢指标比较,差异无统计学意义(P0.05)。MS患者中H.pylori阳性组的BMI、DBP、CHOL水平显著升高。H.pylori阳性组中有胃炎伴糜烂或有消化性溃疡者BMI、SBP、DBP、TG、CHOL水平高于轻度胃炎者(P0.05)。结论 H.pylori感染不仅引起胃黏膜损伤,同时增加MS的患病风险,并促进MS进一步发展。对于年龄小于60岁人群H.pylori感染可引起血脂、血糖、血压等代谢紊乱的发生。H.pylori感染合并慢性胃炎伴糜烂或溃疡者MS患病率较单纯胃炎者MS患病率增加,说明更强的炎症反应增加MS患病风险。     

10d序贯疗法对根除幽门螺杆菌疗效的随访研究

背景:幽门螺杆菌(H.pylori)与慢性胃炎、消化性溃疡、胃癌和胃黏膜相关淋巴组织(MALT)淋巴瘤密切相关,但标准三联疗法的根除率逐年下降。目的:比较10 d序贯疗法和三联疗法根除H.pylori的疗效。方法:将经快速尿素酶试验(RUT)和~(14)C-尿素呼气试验(UBT)证实为H.pylori阳性的106例消化性溃疡、慢性糜烂性胃炎和萎缩性胃炎患者随机分为以雷贝拉唑为基础的10 d序贯疗法组(n=56)和三联疗法组(n=50)。治疗结束4周后复查RUT和,~(14)C-UBT,评估H.pylori根除情况;随访1年后再复查~(14)C-UBT评估H.pylori复发情况。结果:共93例患者按方案完成治疗。10 d序贯疗法组H.pylori根除率按意向治疗(ITT)和按方案(PP)分析均显著高于三联疗法组(ITF:89.3%对62.0%,P0.01;PP:94.3%对77.5%,P0.05);10 d序贯疗法组不良反应发生率(7.1%对30.0%,P0.01)和随访1年后的H.pylori复发率(6.0%对25.8%,P0.01)均显著低于三联疗法组。结论:以雷贝拉唑为基础的10 d序贯疗法可明显提高H.pylori根除率,提高患者的依从性,减少不良反应的发生。     

影响慢性胃炎患者幽门螺杆菌根除的临床因素分析

背景:幽门螺杆菌(H.pylori)感染与慢性胃炎和消化性溃疡密切相关,然而,目前临床普遍采用的三联疗法对相当一部分患者的H.pylori根除无效。目的:探讨影响慢性胃炎患者H.Pylori根除的主要临床因素。方法:取128例H.pylori阳性的慢性胃炎患者的内镜活检标本行H.pylori培养和药敏试验,以奥美拉唑+克拉霉素+甲硝唑的7 d三联疗法行H.pylori根除治疗,以PCR-RFLP法检测CYP2C19基因型。分析不同因素对H.pylori根除率的影响。结果:共123例完成治疗,H.pylori根除率按ITT和按PP分析分别为66.4%和69.1%。H.pylori对甲硝唑和克拉霉素的耐药率分别为48.4%和14.1%。有吸烟史者的H.pylori根除率显著低于无吸烟史者(37.0%对88.3%,P0.01)。甲硝唑敏感菌株和克拉霉素敏感菌株的根除率均显著高于相应的耐药菌株(90.5%对46.7%,P0.01;76.6%对18.8%,P0.01)。CYP2C19强代谢型的根除率显著低于弱代谢型(63.4%对 86.7%,P0.05)。不同性别、年龄以及是否饮酒的患者之间H.pylori根除率差异均无统计学意义(P0.05)。结论:H.pylori对抗生素耐药和宿主CYP2C19强代谢型是导致H.pylori根除失败的主要原因,吸烟史对根除失败亦具有一定的意义。     

经内镜氩离子凝固术治疗隆起糜烂性胃炎的价值及安全性

目的 探讨经内镜氩离子凝固术（APC）治疗隆起糜烂性胃炎（EGP）的价值及安全性.方法 选取100例EGP患者分为观察组与对照组（各50例）,观察组行APC治疗,合并幽门螺杆菌（H.pylori）感染者服用兰索拉唑、阿莫西林、克拉霉素治疗7d,无H.pylori感染者口服兰索拉唑治疗,治疗8周后患者复查胃镜评价疗效.结果 手术过程顺利,未发生灼伤、穿孔等严重并发症;观察组患者症状改善明显优于对照组（P＜0.05）,观察组症状治疗总有效率（98.00％）明显高于对照组（84.00％）（P＜0.05）,观察组患者内镜下观察病灶改善明显优于对照组（P＜0.05）,观察组内镜下治疗总有效率（100％）明显高于对照组（66.00％）（P＜0.05）,观察组隆起糜烂病灶减少率（91.14％）高于对照组（42.27％）（P＜0.05）,H.pylori阳性患者治疗转阴率为81.58％,对照组为74.29％,差异无统计学意义（P＞0.05）.结论 经内镜APC治疗疗效确切,明显高于单纯药物治疗,手术安全性高,值得临床推广.     

幽门螺杆菌感染在女性不孕症发病机制中的作用

背景：幽门螺杆菌（H.pylori）感染与多种胃肠道疾病、甲状腺炎、特发性血小板减少性紫癜、冠状动脉硬化性心脏病等疾病相关。H.pylori的鞭毛与精子鞭毛存在抗原同源性,其鞭毛抗体与精子存在交叉反应,从而可能影响女性的生殖功能。目的：探讨H.pylori感染对女性孕育功能的影响。方法：联合应用13C-尿素呼气试验（UBT）和血清H.pylori-IgG测定检测40例不孕症患者和50名正常生育者的H.pylori感染率;应用酶联免疫吸附测定（ELISA）检测不孕症患者卵泡液H.pylori-IgG阳性率以及血清、卵泡液、宫颈黏液抗精子抗体（AsAb）-IgG和AsAb-IgM阳性率。结果：不孕症组和对照组H.pylori感染阳性率分别为52.5%和30.0%,差异有统计学意义（P〈0.05）。不孕症组H.pylori感染和未感染者卵泡液H.pylori-IgG阳性率分别为90.5%和5.3%,差异有统计学意义（P〈0.01）。不孕症组H.pylori感染者血清、卵泡液、宫颈黏液AsAb-IgG、AsAb-IgM阳性率均显著高于未感染者（P〈0.05）。结论：H.pylori感染与女性不孕症之间存在相关性,可能是女性不孕症发生的危险因素之一。     

消化性溃疡与ABO血型、Lewis表型分布及幽门螺杆菌感染的相关性研究

目的探讨消化性溃疡（PU）与ABO血型、Lewis表型的分布及幽门螺杆菌（H．pylori）感染的关系。方法70例消化性溃疡患者为研究组,96例健康志愿者为对照组,比较ABO血型、Lewis表型分布和H．pylori感染的差异。结果PU组O型血者占52．9％,明显高于O型血在正常人群中的分布（31．3％,P〈0．05）;在非O型血患者中Lewis表型为Le（a＋b＋）者占51．5％,明显高于Le（a＋b＋）表型在对照组非O型血中的频率（9．1％,P〈0．001）。PU组不同ABO血型者H．pylori感染率比较无统计学差异（P〉0．05）;PU组Le（a-b＋）表型者H．pylori感染率为67．6％,明显高于其他Lewis表型（P〈0．05）。结论ABO血型中O型血者易患消化性溃疡,且非O型血Lewis表型为Le（a＋b＋）者也是消化性溃疡的高危人群。ABO血型间H．pylofi感染比较无显著性差异,Le（a-b＋）表型可能是H．pylori感染的一个危险因素。     

A low prevalence of H pylori and endoscopic findings in HIV-positive Chinese patients with gastrointestinal symptoms

AIM： To compare the prevalence of H pylori infection, peptic ulcer, cytomegalovirus （CNV） infection and Candida esophagitis in human immunodeficiency virus （HIV）- positive and HIV-negative patients, and evaluate the impact of CD4 lymphocyte on H pylori and opportunistic infections.
METHODS： A total of 151 patients （122 HIV-positive and 29 HIV-negative） with gastrointestinal symptoms were examined by upper endoscopy and biopsy. Samples were assessed to determine the prevalence of Hpylori infection, CMV, candida esophagitis and histologic chronic gastritis.
RESULTS： The prevalence of Hpylori was less common in HIV-positive patients （22.1%） than in HIV-negative controls （44.8%; P 〈 0.05）, and the prevalence of H pylori displayed a direct correlation with CD4 count stratification in HIV-positive patients. In comparison with HIV-negative group, HIV-positive patients had a lower incidence of peptic ulcer （20.7% vs 4.1%; P 〈 0.01）, but a higher prevalence of chronic atrophy gastritis （6.9% vs 24.6%; P 〈 0.05）, Candida esophagitis and CMV infection. Unlike HIV-negative group, H pylori infection had a close relationship to chronic active gastritis （P 〈 0.05）. In HIV-positive patients, chronic active gastritis was not significantly different between those with Hpylori infection and those without.
CONCLUSION： The lower prevalence of H pylori infection and peptic ulcer in HIV-positive patients with gastrointestinal symptoms suggests a different mechanism of peptic ulcerogenesis and a different role of H pylori infection in chronic active gastritis and peptic ulcer. The pathogen of chronic active gastritis in HIV-positive patients may be different from the general population that is closely related to Hpylori infection.     

A low prevalence of H pylori and endoscopic findings in HIV-positive Chinese patients with gastrointestinal symptoms

AIM: To compare the prevalence of H pylori infection,peptic ulcer,cytomegalovirus (CMV) infection and Candida esophagitis in human immunodeficiency virus (HIV)-positive and HIV-negative patients,and evaluate the impact of CD4 lymphocyte on H pylori and opportunistic infections. METHODS: A total of 151 patients (122 HIV-positive and 29 HIV-negative) with gastrointestinal symptoms were examined by upper endoscopy and biopsy. Samples were assessed to determine the prevalence of H pylori infection,CMV,candida esophagitis and histologic chronic gastritis. RESULTS: The prevalence of H pylori was less common in HIV-positive patients (22.1%) than in HIV-negative controls (44.8%; P < 0.05),and the prevalence of H pylori displayed a direct correlation with CD4 count stratification in HIV-positive patients. In comparison with HIV-negative group,HIV-positive patients had a lower incidence of peptic ulcer (20.7% vs 4.1%; P < 0.01),but a higher prevalence of chronic atrophy gastritis (6.9% vs 24.6%; P < 0.05),Candida esophagitis and CMV infection. Unlike HIV-negative group,H pylori infection had a close relationship to chronic active gastritis (P < 0.05). In HIV-positive patients,chronic active gastritis was not significantly different between those with H pylori infection and those without. CONCLUSION: The lower prevalence of H pylori infection and peptic ulcer in HIV-positive patients with gastrointestinal symptoms suggests a different mechanism of peptic ulcerogenesis and a different role of H pylori infection in chronic active gastritis and peptic ulcer. The pathogen of chronic active gastritis in HIV-positive patients may be different from the general population that is closely related to H pylori infection.     

A low prevalence of H pylori and endoscopic findings in HTV-positive Chinese patients with gastrointestinal symptoms

AIM: To compare the prevalence of H pylori infection,peptic ulcer, cytomegalovirus (CMV) infection and Candida esophagitis in human immunodeficiency virus (HIV)-positive and HIV-negative patients, and evaluate the impact of CD4 lymphocyte on H pylori and opportunistic infections.METHODS: A total of 151 patients (122 HIV-positive and 29 HIV-negative) with gastrointestinal symptoms were examined by upper endoscopy and biopsy. Samples were assessed to determine the prevalence of H pylori infection,CMV, candida esophagitis and histologic chronic gastritis.RESULTS: The prevalence of H pylori was less common in HIV-positive patients (22.1%) than in HIV-negative controls (44.8%; P ＜ 0.05), and the prevalence of H pylori displayed a direct correlation with CD4 count stratification in HIV-positive patients. In comparison with HIV-negative group, HIV-positive patients had a lower incidence of peptic ulcer (20.7% vs 4.1%; P ＜ 0.01), but a higher prevalence of chronic atrophy gastritis (6.9% vs 24.6%; P ＜ 0.05), Candida esophagitis and CMV infection. Unlike HIV-negative group, H pylori infection had a close relationship to chronic active gastritis (P＜0.05). In HIV-positive patients, chronic active gastritis was not significantly different between those with H pylori infection and those without.CONCLUSION: The lower prevalence of H pylori infection and peptic ulcer in HTV-positive patients with gastrointestinal symptoms suggests a different mechanism of peptic ulcerogenesis and a different role of H pylori infection in chronic active gastritis and peptic ulcer.The pathogen of chronic active gastritis in HIV-positive patients may be different from the general population that is closely related to H pylori infection.     

慢性胃炎患者胃内pH值相关因素分析

背景：传统观点认为胃酸分泌随年龄增加和胃黏膜萎缩而减少,但也有研究持不同观点。目的：研究慢性胃炎患者胃内pH值与性别、年龄、糖尿病、萎缩和幽门螺杆菌（H.pylori）感染之间的相关性。方法：共纳入67例慢性胃炎患者,采用pH试纸测定胃液pH值,病理切片结合快速尿素酶试验或^13C-尿素呼气试验检测H.pylori感染情况。分析不同因素与慢性胃炎患者胃内pH值的相关性。结果：67例患者中,慢性非萎缩性胃炎患者35例（52．2％）,慢性萎缩性胃炎32例（47．8％）;H.pylori阳性21例（31．3％）,H.pylori阴性46例（68．7％）。平均胃内pH值为2．86,胃内pH值随年龄增长呈升高的趋势（P=0．15）。Logistic回归分析显示胃内pH值与性别（P=0．17）、年龄（P=0．06）、糖尿病（P=0．75）、萎缩（P=0．67）和H.pylori感染（P=0．11）均无相关性。结论：性别、年龄、糖尿病、萎缩和H.pylori感染不是影响慢性胃炎患者胃内pH值的重要因素。     

Prevalence of Helicobacter pylori infection, endoscopic gastric findings and dyspeptic symptoms among a young Japanese population born in the 1970s

BACKGROUND: With the prevalence of Helicobacter pylori (H. pylori) infection rapidly decreasing in Japan, endoscopic findings and dyspeptic symptoms need to be re-evaluated. METHODS: In a health check-up program, endoscopy was performed on 530 young Japanese subjects (371 men and 159 women) born in the 1970s. Helicobacter pylori infection was evaluated using serology and a rapid urease test. Endoscopic gastritis was classified according to the Sydney classification system, in addition to nodular gastritis. Dyspeptic symptoms were also recorded before endoscopy. RESULTS: Of the 530 subjects, 87 (16.4%) were H. pylori positive. Of the 443 H. pylori-negative subjects, 349 (78.8%) were considered to have endoscopically normal gastric mucosa. However, of the 87 H. pylori-positive subjects, only 19 (21.8%) tested normal (P < 0.001). The prevalence of several types of gastritis was significantly higher in H. pylori-positive subjects compared with H. pylori-negative subjects: atrophic gastritis (37.9% vs 1.1%, P < 0.001), flat erosive gastritis (29.9% vs 7.2%, P < 0.001), rugal hyperplastic gastritis (12.6% vs 0.0%, P < 0.001), and nodular gastritis (13.8% vs 0.0%, P < 0.001). Other types of gastritis were not related to H. pylori status. The prevalence of subjects with dyspeptic symptoms was significantly higher in H. pylori-positive subjects compared with H. pylori-negative ones (28.7% vs 6.5%, P < 0.001). CONCLUSION: It is suggested that in consideration of its recent low prevalence and the slow increase in its infection, the prevalence of H. pylori-related gastritis will gradually decrease in Japan. Further studies will be required to ascertain if there is a need for H. pylori eradication in this young population.