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。

The relationship between Helicobacter pylori infection and gastroesophageal reflux disease

The relationship of Helicobacter pylori （H. pylori） infection and gastroesophageal reflux disease （GERD） remains unclear. Some epidemiological studies showed that reduced prevalence of H. pylori and cagA-positive strains was associated with increased severity of GERD. Other studies indicated that H. pylori infection was not associated with GERI）. Protective mechanisms of H. pylori infection on esophagus may involved in increased esophageal sphincter pres- sure, induction of corpus atrophy and influence on esophageal hypersensitivity. It has been showed that in patients with GERD treated with proton pump inhibitors （PPI） , their intragastric pH increased significantly when H. pylori was pres- ent. However, some studies indicated that H. pylori had no effect on the treatment of GERD. Thus, further studies are needed to evaluate the effect of Helicobacter pylori on gastroesophageal reflux disease.