Manes G, Esposito P, Lioniello M, Bove A, Mosca S, Balzano A
Department of Gastroenterology, Cardarelli Hospital, Naples, Italy.
Dig Liver Dis. 2000 Jun-Jul;32(5):372-7. doi: 10.1016/s1590-8658(00)80255-8.
The role of Helicobacter pylori in the pathogenesis and evolution of gastro-oesophageal reflux disease is still debated.
To investigate the impact of Helicobacter pylori infection on the oesophageal function and on intra-gastric and intra-oesophageal pH in patients with gastro-oesophageal reflux.
Fifty patients with non-complicated-gastro-oesophageal reflux disease classified according to Savary-Miller in: grade O, n=24; grade 1, n=19; grade 2, n=6; grade 3, n=1. Of these patients, 24 were Helicobacter pylori positive and 26 negative. Patients underwent, on two different days, stationary oesophageal manometry and 24-hour gastro-oesophageal pH-metry.
No difference was observed between Helicobacter pylori infected and non-infected individuals with regard to lower oesophageal sphincter function, oesophageal peristalsis and gastrooesophageal reflux. These parameters were more impaired in individuals with erosive gastro-oesophageal reflux disease but this result was not dependent on the Helicobacter pylori status. Helicobacter pylori did not influence the pattern of gastric pH; however, considering only individuals with non-erosive gastro-oesophageal reflux disease, gastric pH was significantly higher in infected individuals, who, histologically, also showed a corpus predominant gastritis.
In patients with gastro-oesophageal reflux disease, Helicobacter pylori does not affect the oesophageal motility or the gastro-oesophageal reflux. These parameters are strictly related to the severity of gastro-oesophageal reflux disease as assessed at endoscopy. In patients with non-erosive gastro-oesophageal reflux disease, a corpus predominant Helicobacter pylori gastritis could be responsible for the less severe gastro-oesophageal reflux.
幽门螺杆菌在胃食管反流病的发病机制及演变过程中的作用仍存在争议。
探讨幽门螺杆菌感染对胃食管反流患者食管功能以及胃内和食管内pH值的影响。
50例非复杂性胃食管反流病患者，根据Savary-Miller分类为：0级，n = 24；1级，n = 19；2级，n = 6；3级，n = 1。其中，24例幽门螺杆菌阳性，26例阴性。患者在两天内分别接受静态食管测压和24小时胃食管pH值测定。
在食管下括约肌功能、食管蠕动和胃食管反流方面，幽门螺杆菌感染组和未感染组之间未观察到差异。这些参数在糜烂性胃食管反流病患者中受损更严重，但这一结果并不取决于幽门螺杆菌感染状态。幽门螺杆菌不影响胃pH值模式；然而，仅考虑非糜烂性胃食管反流病患者，感染患者的胃pH值显著更高，且组织学上也显示胃体为主的胃炎。
在胃食管反流病患者中，幽门螺杆菌不影响食管动力或胃食管反流。这些参数与内镜检查评估的胃食管反流病严重程度密切相关。在非糜烂性胃食管反流病患者中，胃体为主的幽门螺杆菌胃炎可能导致胃食管反流较轻。
