幽门螺杆菌感染与反流性食管炎发病及临床症状相关性研究

目的]探讨幽门螺杆菌(Helicobacter pylori,Hp)感染与反流性食管炎(Relux esophagitis,Re)的发病率以及临床症状严重程度之间的关系,为合理治疗Re提供临床依据.方法]选取2010年4月至2014年4月来本院行胃镜检查确诊的Re患者2028例作为研究对象,根据洛杉矶分类法分级标准,将纳入的患者分为A~D级,比较不同级别患者Hp感染率,随机将检测的Hp阳性Re患者分为观察组和对照组,观察组第1周给予三联法根除Hp治疗(口服雷贝拉唑10 mg,每天2次+克拉霉素500 mg,每天2次+阿莫西林1000 mg,每天2次),然后给予口服雷贝拉唑10 mg,每天2次;对照组给予口服雷贝拉唑10 mg,每天2次,两组疗程均8周,治疗结束后观察两组患者临床症状改善情况.结果]Re患者Hp阳性率为45.91%,其中A级感染率为56.48%、B级为48.77%,C级为37.24%,D级为32.54%.随着Re疾病严重程度的增加,Hp感染率降低,两者呈反比关系;经随机对照研究,两组临床症状积分均较治疗前显著降低(P<0.05),但组间没有统计学意义(P>0.05).结论]Hp感染与Re临床症状呈负相关,推测Hp在Re疾病中具有一定的保护作用,根除Hp后能显著改善Re患者临床症状.

Relationship Between Helicobacter pylori Infection and Incidence and Clinical Symptoms of Reflux Esophagitis

Objective]To investigate the relationship between Helicobacter pylori(Hp)infection and incidence and clinical symptoms of reflux esophagitis (Re),and to a provide clinical basis for rational treatment of Re.Methods]A total of 2028 patients with reflux esophagitis who were treated from April 2010 to April 2014 were chosen as test subj ects.All subj ects were divided into the levels from A to D according to the Los-Angeles stand-ard,and compared the incidence of Hp infection in the patients with Re.Patients diagnosed with Re and Hp posi-tive were randomly divided into the treatment group and the control group,the first week of the treatment group were given standard triple therapy for Hp eradication (rabeprazole with 10 mg bid +clarithromycin 500 mg bid +amoxicillin 1000 mg bid ),and after that,oral administration of rabeprazole with 10 mg bid.The control group was treated with rabeprazole with 10 mg bid,after 8 weeks treatment,clinical symptoms were observed.Re-sults]The incidence of Hp was 45.91% in the patients with Re,among the patients with Re ranging from A to D, the incidence of Hp infection was 56.48% in the patients with grade A,48.77% in the patients with grade B, 37.24% in the patients with grade C,32.54% in the patients with grade D.With the aggravation of severity of the Re,the incidence of Hp infection was decreased,showing a negative correlation between the two.Randomized con-trolled study found that the two groups'clinical symptom score were significantly lower post-treatment than pre-treatment (P <0.05),but there was no statistical significance between two groups (P >0.05).Conclusion]Hp infection may be a protective factor for Re.After Hp eradication,clinical symptoms in patients with Re were sig-nificantly improved.