Do non-steroidal anti-inflammatory drugs or smoking predispose to Helicobacter pylori infection?

Susceptibility to Helicobacter pylori infection is a poorly understood phenomenon. This study was undertaken to establish whether either smoking or chronic non-steroidal anti-inflammatory drug (NSAID) consumption might in some way predispose to H. pylori infection and hence lead to peptic ulceration. Serological evidence of H. pylori infection was assessed in 100 consecutive subjects receiving NSAIDs without any evidence of gastrointestinal upset and 100 matched controls. All subjects had a full assessment of their smoking habits. Sixty-three per cent of patients taking NSAIDs compared to 51% of controls had evidence of H. pylori infection (NS). Smoking habit also had no effect on H. pylori colonization. The ulcerogenic potential of NSAIDs and smoking does not appear to be mediated via a prediposition to H. pylori infection.     

胃癌前病变与幽门螺杆菌感染

目的了解胃癌前病变组织Hp感染状况.方法采用美蓝染色检测126例慢性浅表性胃炎(CSG)、88例慢性萎缩性胃炎(CAG)、73例肠上皮化生(IM)、32例不典型增生(Dys)胃粘膜Hp感染状况.观察胃粘膜炎症反应程度.结果Hp感染率在CAG(65.9%)、IM(63.0%)、Dys(62.5%)组显著高于CSG(42.1%)组(P＜0.05;P＜0.01,P＜0.01)轻度及中度CAG(78.9%,70.4%)显著高于重度CAG组(39.1%)(I＜0.01,P＜0.05);轻度及中度IM(80%,69.6%)显著高于重度IM组(30%)(P＜0.01).胃粘膜单个核细胞、分叶核细胞浸润程度Hp阳性组较Hp阴性组显著增多(I＜0.01).结论Hp感染引起胃粘膜炎症反应,在胃癌前病变的发生中起着重要作用.随着胃粘膜萎缩和肠化的加重.Hp难于生存,其致病性减弱.     

Carbohydrates in Helicobacter pylori infection

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幽门螺力感染的治疗

幽门螺杆菌在儿童时期就可以感染胃 ,并引起终生的慢性胃炎 ,而后者可以引起消化性溃疡病。根治幽门螺杆菌的感染就可以根治消化性溃疡1 5。由于在成年人中幽门螺杆菌的再感染非常罕见6 ,因此这种过去呈慢性复发性的严重疾病在经过了充分的治疗后 ,是可以永久根治的。如果溃疡没有复发 ,也没有溃疡穿孔或出血 ,病人的生命质量可以提高7,病假减少 ,因看病和购买药物导致的花费也会减少。在设计幽门螺杆菌的治疗方案时 ,抗生素的耐药问题需要加以考虑8。过去的10多年里 ,人们提出了多种不同的治疗方法和建议。变化之快 ,使许多医生迷失了方向 …     

Helicobacter pylori serology and the diagnosis of H. pylori infection in children

Serological screening accuracy rate may be dependent on clinical and pathological determinants. The aim of this study was to evaluate the accuracy of Hp serology test (Roche Biomedical Lab., Labcorp), in the diagnosis of Hp infection in 121 children who were seen in the Pediatric Gastoenterology Clinic at the Marshall University Joan C. Edwards School of Medicine in Huntington. Positive serology detected children with Hp-associated gastritis with a sensitivity of 51.6%. Positive serology significantly correlated with the degree of gastric inflammation and density of Hp organisms in the gastric mucosa (ANOVA p < 0.001). The Labcorp. Hp-ELISA test had a poor accuracy rate for the detection of Hp-gastritis in children. Gastric biopsies should always be performed to establish the diagnosis of Hp infection in children.     

Reflux oesophagitis and Helicobacter pylori infection in elderly patients.

Helicobacter pylori is associated with gastritis, peptic ulcers and gastric malignancies. Little attention has been paid to the possibility that it may also have a role in the pathogenesis of reflux oesophagitis. This is especially true in elderly patients who have life-long infection and provide an ideal group to study the mucosal changes associated with the organism. The aim of this study was to determine if H pylori is associated with reflux oesophagitis in elderly patients. Consecutive gastroscopy patients were recruited. Multiple biopsies were taken from oesophagus, stomach, antrum and duodenum for histology and rapid urease tests. Patients also had IgG ELISA antibodies and 13C-urea breath tests performed. Patients with macroscopic or microscopic evidence of reflux oesophagitis were compared to patients with macroscopically normal upper gastrointestinal tracts and no microscopic evidence of reflux. A total of 114 patients were recruited, average age 78.9 years (+/- 5.4). There were 37 refluxers and 33 non-refluxers. We found no evidence for an association between the presence of H pylori and reflux oesophagitis in elderly patients. The high prevalence of H pylori in patients with reflux oesophagitis can be explained by the presence of incidental gastritis.     

幽门螺杆菌感染与抑郁症的关联性研究

目的:探讨幽门螺杆菌(Hp)与抑郁症是否具有关联性,Hp根除治疗对抑郁症患者病情的影响。方法:抑郁症患者共131例,行14C-尿素呼气试验分为Hp感染组(101例)和未感染组(30例),使用汉密尔顿(HAMD)抑郁量表进行抑郁评分。Hp感染组随机分为试验组(55例)和对照组(46例),试验组进行规范Hp根除治疗,两组同时依病情使用SSR、ISNR I及NaSSA类抗抑郁药,4周后再次行HAMD抑郁评分。结果:Hp感染组与非感染组HAMD抑郁评分分别为26.55±5.94、17.90±5.65,t=7.085,P=0.000。试验组与对照组治疗前后HAMD抑郁评分差值分别为9.27±7.73、4.93±5.00,t=3.398,P=0.001。结论:幽门螺杆菌感染与抑郁症相关,Hp根除治疗对抑郁症患者的病情好转有显著促进作用。     

儿童胃炎与幽门螺杆菌感染

目的 研究儿童胃炎的病理变化及其与幽门螺杆菌感染的关系。方法 对我科１９９６年至１９９８年间１００例３至１５岁儿童胃镜活检组织进行组织学观察,按１９９６年的Ｓｙｄｎｅｙ胃炎标准对病变分级,分析和探讨儿童慢性胃炎的病理特点。结果 ４９％的儿童胃炎与幽门螺杆菌感染有关,而且炎症的程度和幽门腺萎缩明显高于无幽门螺杆菌感染的病例。     

幽门螺杆菌全菌疫苗研究进展

幽门螺杆菌(helicobacter pylori,p)是定植于人胃内的革兰染色阴性、螺杆状、微需氧菌,目前全球近50%的人口感染了Hp,在发展中国家,其感染率可高达70%以上.Hp的抗感染治疗存在较大问题,使用单剂药物根除率低,而使用多联药物费用昂贵,治愈率不高且不能有效阻止Hp的再感染和复发.此外,耐药菌株的增加也使抗Hp治疗面临越来越复杂的难题,种种因素使Hp疫苗有望成为预防和治疗Hp感染最有效的途径.这也并不是说用有效的疫苗就能克服抗生素治疗缺点,但特定的疫苗治疗,可以根除感染,同时还能提供适当的免疫记忆,避免再感染,而这一点是抗生素永远不能办到的.     

幽门螺旋杆菌感染时血清胃泌素水平变化观察

目的：了解幽门螺旋杆菌感染与血清胃泌素的关系。方法：采用RIA方法检测186例门诊行胃镜检查患者血清胃泌素浓度,同时以∧14C-尿素呼气试验检查是否存在幽门螺旋杆菌感染。结果：幽门螺旋杆菌感染阳性患者血清胃泌素水平明显高于未感染者。结论：幽门螺旋杆菌引起血清胃泌素增高进而造成胃酸分泌增多,可能是幽门螺旋杆菌感染致病机制之一。     

Helicobacter pylori.

Since 1983, rapid advances in the knowledge of Helicobacter pylori have given new insights into the pathogenesis of upper gastrointestinal diseases. Several methods are now available for the diagnosis of the infection. Antimicrobial therapy has emerged as a new and effective treatment for peptic ulcer disease in a proportion, as yet to be determined, of patients in the Caribbean.     

幽门螺杆菌感染与Barrett食管关系的研究

目的 探讨幽门螺杆菌(Helicobacter priori,Hp)与Barrett食管发生的关系.方法 共收集206例患者,其中Barrett食管患者106例(肠化型36例),GERD患者50例,另选无上诉疾病者50例作为正常对照.采用快速尿素酶法(rapid urease test,RUT)及Warthin-Starry银染两种方法检测Hp感染.结果 正常对照组、GERD组、Barrett食管组以及Barrett食管肠化组食管下段黏膜Hp检出率分别为10.0%(5/50)、20.0%(10/50)、15.1%(16/106)和16.7%(6/36).虽然后3组食管下段Hp检出率略高于对照组,但各组间Hp检出率无显著性差异(P>0.05).胃窦部Hp的检出率在正常对照组为60.0%(30/50),GERD组为32.0%(16/50),Barrett食管组为31.1%(33/106),Barrett食管肠化组为30.6%(11/36).GERD和Barrett食管胃窦部Hp检出率显著低于正常组.结论 Hp对GERD及Barrett食管可能有保护作用.     

幽门螺杆菌感染与缺血性心脑病的关系探讨

目的：探讨幽门螺杆菌（HP）感染与缺血性心脏病（IHD）的关系以及可能的发病机理。方法：应用酶联免疫法测定IHD组（142例）和对照组（50例）血清特异性HP抗体（HPIgG),用全自动生化仪测定血清TC,TG＜ApoA1,ApoB,Lp(a),HDL-c,LDL-c含量,应用全自动凝血仪测定血中纤维蛋白原浓度（Fbg),化学比色法测定血清中NO和NOS含量。结果：IHD组血清HPIgG阳性率明显高于对照组（65．49％VS28．00％,P＜0．0001）,经多元回归分析显示HP感染与IHD发病呈明显的正相关（P＝0．0004）,HPIgG阳性者的TG,ApoB,NO,NOS含量明显增高（P＜0．05）,TC,Lp(a),LDL-c,Fbg含量有增高趋势。结论：HP感染与IHD的发生有明显的相关性,其可能的发病机理为HP感染改变了脂质代谢和血管的内皮功能来增加发生IHD的危险。     

反流性食管炎与幽门螺杆菌感染的关系

目的观察反流性食管炎(reflux esophagitis,RE)与幽门螺杆菌(Helicobacter pylori,Hp)感染的关系。方法收集经过胃镜确诊的RE患者235例及慢性浅表性胃炎患者235例,行反流性疾病问卷(reflux diagnosticquestionnaire,RDQ)调查,并在内镜下取两块黏膜组织采用快速尿素酶试验结合病理学检查(Giemsa染色)判断Hp是否感染,比较两组患者RDQ分数及Hp感染情况。结果两组人群平均年龄、性别比较,差异无统计学意义(P>0.05);RE组患者的RDQ为(12.8±0.5)分,慢性浅表性胃炎组的RDQ为(6.1±0.2)分,两组差异有统计学意义(P<0.01);RE组患者的Hp(+)感染数为111(49.8%),慢性浅表性胃炎组Hp(+)感染数为124(52.8%),两组差异无统计学意义(P>0.05)。结论反流性食管炎的发生与幽门螺杆菌感染无明显关系。     

幽门螺杆菌感染时血清胃泌素、生长抑素的表达

目的：了解幽门螺杆菌感染与血清胃泌素及生长抑素变化的关系。方法：采用ＲＩＡ法检测１２８例门诊行胃镜检查患者血清胃泌素，生长抑素浓度；同时以ＣＬＯ、ＥＬＩＳＡ法检查患者是否存在幽门螺杆菌感染。结果：幽门螺杆菌感染阳性患者血清胃泌素水平明显高于未感染者；而生长抑素水平则无差异。结论：幽门螺杆菌引起血清胃泌素增高进而造成胃酸分泌增多，可能是幽门螺杆菌感染致病机制之一。     

幽门螺杆菌感染与慢性荨麻疹的关系

目的探讨幽门螺杆菌（Helicobacter pylori,Hp）感染与慢性荨麻疹（chronic urticaria,CU）发病之间的关系。方法对61例慢性荨麻疹患者及35例健康对照者进行14C尿素呼气试验（14C-urea breath test,14C-UBT）及检外周静脉血Hp抗体,比较两组Hp阳性率。数据采用SPSS10.0软件进行统计学处理,率的比较用χ^2检验,P〈0.05为差异有统计学意义。结果慢性荨麻疹患者与健康对照组之间Hp感染阳性率差异有统计学意义（75.40%vs40.00%,χ^2=12.66,P〈0.01）。结论慢性荨麻疹的发病可能与Hp感染有关系。     

幽门螺杆菌感染中细胞因子的调控

大量的基础与临床研究结果表明,细胞因子在幽门螺杆菌(Hp)相关性疾病的发生发展及转归中起着十分重要的介导作用。Hp、宿主和相伴的环境因素之间的相互作用决定了Hp感染的不同临床表现和结局,而细胞因子始终参与这一过程。     

Association of Helicobacter pylori infection and gastric carcinoma

Gastric carcinoma is a worldwide disease, representing the second most frequent cancer in the world. Gastric carcinogenesis is a multifactoral process and it results from interaction of the several factors that are related to diet, environment, genetic susceptibility, and Helicobacter pylori (H. pylori) infection. Many evidence showed that H. pylori, the important pathogen for a wide spectrum of gastro duodenal diseases. Substantial epidemiological evidence exists for an increased risk of gastric carcinoma with H. pylori infection. This study was conducted with the objective to find out an association of H. pylori infection and gastric carcinoma in a Bangladeshi population. This case-control study was conducted between June 2003 and July 2004, in the department of Surgery in joint collaboration with department of Pathology and Department of Microbiology and Immunology in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. A total number of 151 subjects were included in this study. Fifty gastric carcinoma patients were considered as cases and 101 control subjects were selected from the admitted patients in the surgical ward having no gastric cancer, but with other gastro duodenal disorders. The mean age±SD among the cases and controls were 51.84±12.69 and 35.08±11.67 years respectively. Among the 50 cases 36(72.0%) and among the 101 controls 74(75.3%) were male. The male and female ratio among the cases and controls were 1:0.39 and 1:0.36 respectively. Among the 50 cases 40(80.0%) and among the 101 controls 62(61.4%) were serologically positive for H. pylori infection. Difference of H. pylori infection in both study groups were evident and statistically significant (OR=2.516, p<0.05). It may be concluded from this study, H. pylori infection may be associated with gastric carcinoma.     

幽门螺杆菌感染与结肠息肉关系的研究

目的探讨幽门螺杆菌（Helicobacter pylori,Hp）感染与结肠息肉的关系。方法经胃、肠镜检查,入选100例结肠息肉,另150例结肠无明显异常者为对照。采用免疫印迹法进行Hp的血清学分型,并取结肠息肉、胃黏膜观察病理组织学变化。结果结肠息肉组Hp阳性率较对照组增高,差别有统计学意义（P=0.038）;与对照组相比,直、乙、降结肠息肉及多发性结肠息肉Hp阳性率增高有统计学意义（P=0.030,P=0.004）。但Hp血清分型的分布无显著差异（P〉0.05）。结论Hp感染可能是结肠息肉发生的一个因素。