幽门螺杆菌感染与反流性食管炎的关系分析

目的:探讨幽门螺杆菌(Hp)感染与反流性食管炎(RE)的相关性。方法:回顾性总结分析胃镜检查确诊反流性食管炎患者97例,同时选取104例慢性胃炎患者为对照。所有病例采用14C呼气试验检测Hp感染。结果:97例反流性食管炎患者中Hp感染率为45.4%,而对照组63.5%(P<0.01);REA、B、C级患者HP阳性率分别为59.4%、42.0%、26.7%,但差异无统计学意义(P>0.05)。结论:Hp感染可能是反流性食管炎的保护因素。     

幽门螺杆菌与胃食管反流病

幽门螺杆菌（Helicobacter pylori，H．pylori）与胃食管反流病（gastroesophageal reflux disease，GERD）的关系各研究结果不尽一致，流行病学研究表明，在GERD中不仅Mpylori感染率较低，而且cagA的检出率也低，二者都与食管疾病严重程度呈负相关。亦有文献报告H．pylori感染与GERD发生无明显关系。H．pylori对食管保护作用机制可能与其能提高LES压力、降低胃内酸度和影响食管对酸的敏感性有关。有研究表明，H．pylori可以提高质子泵抑制剂的抑酸效果，亦有人认为H．pylori并不影响GERD疗效。因此H．pylori与GERD的关系仍需进一步的临床和基础研究来评价。     

Inverse association between Helicobacter pylori infection and allergic rhinitis in young Japanese

Background and Aim: The prevalence of allergic disorders, including asthma, atopic dermatitis, and allergic rhinitis has been increasing, and the prevalence of Helicobacter pylori (H. pylori) infection has been decreasing. Chronic bacterial infection during childhood is reported to protect the development of allergic diseases. The aim of the present study was to identify whether H. pylori infection influences the prevalence of allergic rhinitis, which has become a serious social problem, especially in the developed countries. Methods: We initially investigated the association between the prevalence of H. pylori and pollinosis symptoms in 97 healthy volunteers. We had investigated the association between the serum H. pylori–immunoglobulin (Ig) G antibodies and specific IgE antibodies for pollen, mites, and house dust in 211 consecutive patients. Results: There were 52.2% (36/69) of H. pylori‐negative volunteers with allergic symptoms, which was significantly higher than H. pylori‐positive volunteers (14.3%, 4/28, P < 0.05). The risk of pollinosis symptoms by H. pylori infection was 0.148 (95% confidence interval): 0.046–0.475, P < 0.05). The prevalence of H. pylori infection increased according to age, whereas that of specific IgE‐positive patients gradually decreased. Among the IgE‐positive patients, the prevalence of H. pylori‐negative patients was significantly higher than H. pylori‐positive patients who were younger in age (P < 0.05). Conclusion: H. pylori infection decreased the pollinosis effects, especially among the younger volunteers. However, the prevalence of pollinosis in patients who were 50 years or older were almost same between H. pylori‐positive and H. pylori‐negative patients; therefore, the recent increase of pollinosis might relate to not only H. pylori infection, but also change in social environment.     

消化性溃疡与幽门螺杆菌L型感染相关性研究

目的　探讨消化性溃疡 (PU)与幽门螺杆菌 L型 (HP- L )感染的关系。方法　取 386例 PU患者胃窦、胃体及十二指肠粘膜组织 ,常规切片后以革兰氏染色和免疫组化染色镜检 HP- L 型细菌 ,并计算检出率。结果　 HP- L 型检出率为 5 3.37% ,其中革兰氏染色和免疫组化染色检出率分别为 5 6 .73%、5 4 .2 9% ,差异无显著性(P>0 .0 5 ) ;胃溃疡、十二指肠溃疡 HP- L 型检出率分别为 5 8.33%、5 5 .5 0 % ,差异无显著性 (P>0 .0 5 ) ;男女患者HP- L 检出率前者 (6 1.18% )明显高于后者 (38.17% ) (P<0 .0 1) ;30岁以下、30岁～、4 0岁～、5 0岁～患者 HP- L检出率依次为 32 .0 5 %、4 1.94 %、5 9.18%、71.79% ,差异显著 (P<0 .0 1)。结论　 PU患者 Hp- L型感染率较高 ,且男性高于女性 ,HP- L型检出率随年龄增长而增高。 PU患者 HP- L型变异可能是导致溃疡迁延不愈、反复发作的重要原因之一     

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。     

Progress in elucidating the relationship between Helicobacter pylori infection and intestinal diseases

Helicobacter pylori (H. pylori) infection causes changes to the intestinal flora, such as small intestinal bacterial overgrowth, and increases gastric acid secretion-stimulating gastrointestinal hormones, mainly gastrin, due to a decrease in gastric acid caused by atrophic gastritis. In addition, the cellular components of H. pylori travel through the intestinal tract, so the bacterial infection affects the immune system. Therefore, the effects of H. pylori infection are observed not only in the stomach and the proximal duodenum but also in the small and large intestines. In particular, meta-analyses reported that H. pylori-infected individuals had an increased risk of colorectal adenoma and colorectal cancer. Moreover, a recent study reported that the risk of developing colorectal cancer was increased in subjects carrying H. pylori vacuolating cytotoxin A antibody. In addition, it has been reported that H. pylori infection exacerbates the symptoms of Fabry’s disease and familial Mediterranean fever attack and is involved in irritable bowel syndrome and small intestinal ulcers. On the other hand, some studies have reported that the frequency of ulcerative colitis, Crohn’s disease, and celiac disease is low in H. pylori-infected individuals. Thus, H. pylori infection is considered to have various effects on the small and large intestines. However, few studies have reported on these issues, and the details of their effects have not been well elucidated. Therefore, additional studies are needed.     

A close relationship between Helicobacter pylori infection and gastric xanthoma.

BACKGROUND: Although the pathogenesis of gastric xanthoma (GX) remains unclear, an association of GX with atrophic gastritis has been reported. Helicobacter pylori is closely related to atrophic gastritis. The aim of this study was to investigate the relationship among GX, H. pylori, and atrophic gastritis. METHODS: Sixty-seven patients with GX were assessed for H. pylori infection by serum anti-H. pylori IgG antibody, in addition to the rapid urease test, culture, and histologic examination using biopsy specimens of the antrum and corpus. The findings were compared with 67 age- and sex-matched control subjects without GX. The distribution of atrophic gastritis was assessed endoscopically. The severity of atrophic gastritis was determined endoscopically and histologically. Serum pepsinogen (PG) levels were also measured. Immunohistochemical staining of GX samples for H. pylori antigen was performed. H. pylori clinical isolates from patients with GX and controls were assessed for cagA by means of polymerase chain reaction. RESULTS: The prevalence of H. pylori was significantly higher in patients with GX than in controls (94% and 72%, respectively). A significantly more extensive atrophic gastritis was present in patients with GX, as determined endoscopically and histologically, than in controls. Serum PG-I levels and the PG-I/PG-II ratio were significantly lower in the GX group than in the control group. H. pylori antigens were frequently identified in the cytoplasm of xanthoma cells in H. pylori-positive specimens of GX (54 of 63 specimens, 86%), whereas no immunoreactivity for H. pylori antigens was detected in H. pylori-negative specimens of GX. There was no significant difference in the positive rate of cagA between the two groups. CONCLUSIONS: Our results identified a close relationship among H. pylori infection, GX, and atrophic gastritis. A proportion of GXs may be provoked by H. pylori infection.     

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。     

幽门螺杆菌感染与缺血性脑卒中及其亚型相关性Meta分析

目的对幽门螺杆菌(Hp)感染与缺血性脑卒中(IS)及其亚型的相关性进行Meta分析,探讨Hp感染是否为IS及其亚型的危险因素。方法计算机检索MEDLINE、EMBASE及Cochrance Collaboration database电子数据库,检索时限为1 995～2009年。由2名评价者对文献的质量进行评价,纳入相关的病例对照研究。采用Cochrane协作网提供的RevMan 5.0软件对纳入文献进行Meta分析,并进一步进行异质性检验、敏感性分析及偏倚评估。结果共纳入11篇相关文献,其中与IS相关9篇(病例组1575例,对照组1 720例),与大动脉粥样硬化性脑卒中(LAA)相关7篇(病例组510例,对照组944例)。异质性检验提示,Hp与IS及LAA的研究间均存在异质性(I~2=58%,I~2=60%)。病例组与对照组的Hp感染率差异存在统计学意义(OR=1.57,95%CI:1.23～1.99);Hp感染与LAA亦存在相关性(OR=2.24,95%CI:1.46～3.43)。敏感性分析提示结果稳定。漏斗图表明存在发表偏倚,提示缺少小样本的阴性结果文献。结论 Hp感染是IS的危险因素,且与LAA的相关性更为密切;病例对照研究论证强度较低,仍需更多大样本及前瞻性研究以证实Hp在IS及其亚型发病中的作用。     

幽门螺杆菌感染与年龄段及家庭成员感染的关系

胃炎、消化性溃疡、原发性粘膜相关性淋巴样组织(musoca associated lymphoid tissue，MALT)淋巴瘤和胃癌均与幽门螺杆菌(Helicobacter pylori，H．pylori)感染存在相关，而且H．pylori感染是儿童消化性溃疡的主要原因。H．pylori感染流行病学特点和危险因素已得到广泛研究，有报道发现，儿童时期H．pylori感染存在不同种族差异。     

十二指肠胃反流和幽门螺杆菌感染关系研究

目的：探讨消化性溃疡患者中的十二指肠胃反流对幽门螺杆菌（Hp)感染的影响。方法：70例消化性溃疡患者，用核素^99MTC-EHIDA测定十二指肠胃反流，胃黏膜Giemsa染色后检测Hp和双抗体夹心ELISA法测定血清Hp-IgG水平。结果：在42例十二指肠胃反流阴性组中，Hp感染率为83．3％（35／42）；28例十二指肠胃反流阳性组中，Hp感染率为39．3％（11／28），两组间Hp感染率差异有显著性（P＜0．05）。而Hp阳性组46例患者中，十二指肠胃反流阳性率为30．4％（14／46）；Hp阴性组24例中，十二指肠胃反流率为58．3％（14／24），两组间十二指肠胃反流率差异也有显著性（P＜0．05）。结论：在消化性溃疡中，十二指肠胃反流对胃内Hp感染可能有抑制作用。     

幽门螺杆菌与消化性溃疡并出血的研究现状

幽门螺杆菌是消化性溃疡的确定性致病因素,其在溃疡并出血的作用尚不十分明确.目前,幽门螺杆菌在消化性溃疡并出血的感染率受检测方法、药物等影响不尽相同.幽门螺杆菌感染在一定程度上增加了消化性溃疡并出血的危险性,从长远上根除幽门螺杆菌可以降低溃疡出血风险,促进溃疡愈合.     

幽门螺杆菌感染与大肠癌的关系

目的:检测幽门螺杆菌(Helicobacter pylori,H.pylori)在大肠癌及其癌前病变(腺瘤性息肉)中的感染情况,探讨H.pylori感染与大肠癌发病的关系.方法:肠癌组、腺瘤组、对照组各40例.肠癌组和腺瘤组分别在肠癌和腺瘤病变处活检,对照组正常大肠黏膜处活检.HE染色明确病变的组织病理学诊断,银染法检测活检黏膜H.pylori的感染情况.结果:肠癌组H.pylori检出率高于对照组,低于腺瘤组,但肠癌组与腺瘤组相比(2=0.524,P=0.469)、肠癌组与对照组相比(2=2.813,P=0.094)差异均无统计学意义(P>0.05).腺瘤组H.pylori检出率高于对照组,差异有统计学意义(2=5.591,P=0.018).结论:大肠癌与大肠腺瘤的H.pylori感染率高于正常对照组,H.pylori局部感染可能是大肠肿瘤发病的一个危险因素.     

胃幽门螺杆菌感染与口腔异味感关系的相关性研究

目的探讨口腔异味感(俗称口臭)的病因与胃幽门螺杆菌感染的相关性。方法随机选择因上消化道症状就诊于我院消化科(无口腔疾病及全身疾病)的353例患者,首先进行口臭测试,根据有无口臭分为口臭组和无口臭组,所有病例均行13C呼气试验,观察各组中幽门螺杆菌感染率。同时根据有无幽门螺杆菌感染分为感染组和无感染组,观察口臭的发生率。结果353例患者中,口臭组166例,占47.03%,其中胃幽门螺杆菌阳性109例(65.66%);无口臭组187例,占52.97%,其中胃幽门螺杆菌阳性68例(36.36%);两组间差异有统计学意义(χ2=30.19,P0.001),口臭与幽门螺杆菌感染两者间相关系数r=0.29。幽门螺杆菌感染阳性177例,感染率为50.14%,其中口臭134例,占75.71%;幽门螺杆菌检测阴性176例,其中口臭32例,占18.19%;两组间差异有统计学意义(χ2=117.22,P0.001),幽门螺杆菌感染与口臭发生率两者间相关系数r=0.58。结论口臭的病因可能与胃幽门螺杆菌感染有较大的相关性,胃幽门螺杆菌感染有可能是导致口臭的一个原因。     

口腔幽门螺杆菌感染与胃幽门螺杆菌感染的相关性探讨

目的 分析口腔和胃幽门螺杆菌(Hp)感染的检测结果,探讨口腔Hp感染与胃Hp感染的相关性,及口腔Hp感染对Hp根除治疗的影响.方法 采用唾液测定螺旋杆菌抗原技术(HPS)和13C/14C尿素呼气试验(UBT)同步检测的方法,对114例有上消化道症状的初诊患者(第1组),129例确诊为胃Hp感染经根除治疗后4周复查的患者(第2组)和33例无消化道症状的健康志愿者(第3组),进行口腔和胃Hp检测.结果 第1组、第2组和第3组HPS阳性检出率分别为77.19%、75.97%和81.82%,3组比较差异无统计学意义(χ2=0.47,P值均>0.05);UBT阳性检出率第1组(52.63%)比第2组(34.11%)和第3组(21.21%)高,第1组与第2组和第3组比较,差异有统计学意义(χ2=8.48和10.19,P均<0.05),第2组与第3组之间差异无统计学意义(χ2=2.03,P>0.05);在UBT阳性者中,HPS阳性检出率差异无统计学意义(3组分别为81.67%、88.64%和100%,χ2=2.25,P值均>0.05).结论 唾液中存在高Hp抗原检出现象,口腔可能是Hp在胃以外的"第二定居地".口服药物治疗对口腔Hp感染几乎无效,口腔Hp的存在可能是胃病发病和复发的一个重要和直接的原因.

Abstract：

Objective To explore association between Helicobacter pylori (Hp) infection in oral cavity and gastric Hp infection through oral cavity and gastric Hp infection testing results analysis, and also to study the effect of Hp infection in oral cavity on Hp eradication treatment. Methods Through Hp saliva test (HPS) and 13C/14C urea breath test (UBT) method, the Hp in oral cavity and stomach were tested in 114 first-visit patients with upper gastrointestinal symptoms (group 1), 129 re-visiting patients who were diagnosed gastric Hp infection with eradication treatment for four weeks (group 2) and 33 volunteers without gastrointestinal symptoms. Results The positive rates of Hp infection by HPS method were 77.19%, 75.97% and 81.82% in group 1, group 2 and group 3 respectively. There was no significant difference between these three groups (χ2=0.47, P>0.05). The positive rate of Hp infection by UBT method in group 1 (52.63%) was higher than those of group 2 (34.11%) and group 3 (21.21%). Compared group 1 with group 2 or group 3, there was significant difference (χ2=8.848, 10.19, P<0.05). There was no significant difference between group 2 and 3 (χ2=2.03, P>0.05). In positive individuals of these three groups tested by UBT method, there was no significant difference of positive rate tested by HPS method (81.67%, 88.64% and 100% of three groups respectively, χ2=2.25, P>0.05). Conclusions The High detection of Hp antigen in saliva indicates that the oral cavity may be the "second settlement" of Hp beside stomach. The oral medicine haslittle effect on oral cavity Hp infection. The existence of oral Hp may be an important and direct factor of incidence and recurrent of gastric diseases.     

幽门螺杆菌感染与胃癌发病关系的文献计量学分析

目的：了解H pylori感染与胃癌关系研究现状,总结研究热点,提供参考信息．方法：采用引文分析方法对国外2001-2006有关该主题的重要文献进行调查分析,并用SPSS对高频被引文献进行聚类分析,根据各个类中的文献内容分析当前研究的热点．结果：H pylori感染与胃癌关系研究的重要文献多数发表于世界著名的综合性刊物上,肿瘤学与胃肠病学核心期刊次之．检得SCI数据库中相关文献1547篇,其参考文献出现频次高于60次论文42篇．高被引论文聚类分析树图分5类．结论：H pylori感染与胃癌流行病学、胃癌动物模型,H pylori感染的根除与胃癌的关系．H pylori感染、宿主细胞因子多态性与胃癌易感性,以及H pylori致病相关基因的为研究热点．     

高原地区幽门螺杆菌感染与急性脑梗死关系的探讨

目的 探讨不同高海拔地区急性脑梗死(acute cerebral ischemic,ACI)与慢性幽门螺杆菌(Hp)感染的关系.方法 13C呼气实验方法和采用免疫比浊法检测不同高海拔地区ACI患者Hp感染率和血清C反应蛋白(CRP)浓度.结果 高海拔ACI组Hp阳性率(82.5%)明显高于中度海拔ACI组(60.4%).在不同海拔地区,ACI组Hp阳性者的CRP水平均比Hp阴性者的高( P＜0.01).通过两个海拔梯度A CI组Hp阳性者CRP水平的比较,高海拔组CRP明显高于中度海拔组.结论 高原地区ACI患者Hp感染后可能诱导机体产生CRP.严重环境因素(高海拔、氧化应激、强紫外线)可能是诱导高原ACI炎症反应发生、发展的原因,提示慢性Hp感染与高原地区ACI的发病密切相关.     

幽门螺杆菌长期感染与胃黏膜炎症和肠上皮化生的关系

目的探讨幽门螺杆菌(Hp)长期感染及根除与胃黏膜炎症和肠上皮化生(IM)的关系。方法随访71例5年前和78例10年前Hp感染者,分析对比其前后Hp感染情况、胃黏膜炎症和IM的变化。结果5年前Hp阳性71例中,现在52例(73.2％)Hp仍呈阳性,19例(26.8％)转阴;10年前Hp阳性的78例中,现在59例(75.6％)Hp仍呈阳性,19例(24.4％)转阴。Hp长期阳性者5年前和现在及10年前和现在慢性炎症严重程度积分分别为1.635±0.376与1.808±0.301(P>0.05)和1.661±0.398与2.232±0.335(P<0.01);IM的发生率分别为17.3％(9/52)与26.9％(14/52)(P>0.05)和11.9％(7/59)与39.0％(23/59)(P<0.01);IM严重程度积分分别为1.444±0.527与1.667±0.442(P>0.05)和1.571±0.534与2.286±0.488(P<0.05)。Hp转阴者5年前和现在及10年前和现在慢性炎症严重程度积分分别为1.684±0.369与1.369±0.426(P<0.05)和1.647±0.389与1.182±0.396(P<0.01);IM的发生率为31.6％(6/19)和52.6％(10/19);IN严重程度积分分别为1.333±0.516与1.167±0.775(P>0.05)和1.600±0.516与1.100±0.316(P<0.05)。结论Hp感染持续时间越长,胃黏膜炎症越严重,IM程度亦越严重且发生率高;根除Hp不仅能减轻胃黏膜的炎症程度和IM程度,而且能防止IM的发生。     

幽门螺杆菌与反流性食管炎的相关性研究

目的探索幽门螺杆菌(Hp)与反流性食管炎的相关性.方法对确诊的43例反流性食管炎及同期条件相匹配的50例慢性胃炎及47例十二指肠溃疡患者采用日产PQ20型0Lympus纤维胃镜检查并取胃粘膜四块用Hp检测试纸行快速尿素酶测定,同时取空腹静脉血用ELISA方法测定血Hp-IgG抗体.Hp阴性的反流性食管炎患者(15例)分为A、B两组A组(n=7)接受法莫替丁(20mg,Bid)治疗,B组(n=8)接受法莫替丁(20mg,Bid)及西沙比利(10mg,Tid),各治疗28天.Hp阳性反流性食管炎患者(28例)分为C、D两组C组(n=14)接受洛赛克(20mg,Bid)及西沙比利(10mg,Tid)治疗,D组(n=14)接受洛赛克(20mg,Bid)、羟氨苄青霉素(0.5,Tid)、呋喃唑酮(0.2,Tid)及西沙比利(10mg,Tid)治疗,各治疗14天.结果1、Hp在反流性食管炎、慢性胃炎、十二指肠溃疡的检出率分别为65.1%、64%及80.8%(P＞0.05).2、Ⅰ、Ⅱ、Ⅲ及Ⅳ级食管炎的百分率分别为30.2%、46.5%、18.6%及4.7%.无Ⅴ级食管炎.各级食管炎患者Hp检出率分别为61.5%、55%、87.5%及100%(P＞0.05).3、A、B组治疗显效率(反流症状消失)为57.1%及100%(P＜0.05).C、D组治疗显效率为64.3%及92.9%(P＞0.05).结论1、Hp与反流性食管炎及其病变程度均无相关性,根除Hp对反流性食管炎本身的治疗似无影响.2、促动力剂在反食性食管炎中有重要作用.