Shirota T, Kusano M, Kawamura O, Horikoshi T, Mori M, Sekiguchi T
First Department of Internal Medicine, School of Medicine, Gunma University, Maebashi, Japan.
J Gastroenterol. 1999 Oct;34(5):553-9. doi: 10.1007/s005350050372.
The role of Helicobacter pylori infection in the development and exacerbation of reflux esophagitis was investigated. The prevalence of Helicobacter pylori infection, the severity of atrophic gastritis, and esophageal motility (determined by esophageal manometry by an infusion catheter method) were assessed in patients with mild (n = 46) and severe (n = 27) reflux esophagitis and subjects without reflux (n = 28). Compared with the prevalence of Helicobacter pylori infection in the non-reflux group, the prevalence in the mild and severe reflux groups (60.7%, 47.8%, and 14.8%, respectively) was significantly (P < 0.05) lower. Atrophic gastritis was milder in both reflux groups than in the non-reflux group. The degree of gastritis was also milder in the severe reflux group than in the mild reflux group. The esophageal sphincter pressure was significantly (P < 0.05) lower in the reflux groups than in the non-reflux group, and the amplitude of primary peristalsis was significantly (P < 0.05) lower in the severe reflux group than in the non-reflux group. There were no significant differences between reflux patients with and without Helicobacter pylori infection in the parameters of esophageal manometry. These data imply that a low prevalence of Helicobacter pylori infection may result in a milder grade of atrophic gastritis, and consequently, exacerbate reflux esophagitis.
研究了幽门螺杆菌感染在反流性食管炎发生和加重过程中的作用。对轻度反流性食管炎患者(n = 46)、重度反流性食管炎患者(n = 27)和无反流受试者(n = 28)评估了幽门螺杆菌感染的患病率、萎缩性胃炎的严重程度以及食管动力(通过输注导管法食管测压确定)。与无反流组相比,轻度和重度反流组的幽门螺杆菌感染患病率(分别为60.7%、47.8%和14.8%)显著较低(P < 0.05)。两个反流组的萎缩性胃炎均比无反流组轻。重度反流组的胃炎程度也比轻度反流组轻。反流组的食管括约肌压力显著低于无反流组(P < 0.05),重度反流组的原发性蠕动幅度显著低于无反流组(P < 0.05)。在食管测压参数方面,幽门螺杆菌感染阳性和阴性的反流患者之间无显著差异。这些数据表明,幽门螺杆菌感染患病率较低可能导致萎缩性胃炎程度较轻,从而加重反流性食管炎。