Pieramico O, Zanetti M V
Division of Internal Medicine, General Hospital F. Tappeiner, Merano, Italy.
Dig Liver Dis. 2000 Oct;32(7):567-72. doi: 10.1016/s1590-8658(00)80837-3.
The role of Helicobacter pylori infection and/or gastro-oesophageal reflux disease in pathogenesis of intestinal metaplasia in gastric cardia is still unclear.
To prospectively evaluate prevalence of inflammation and intestinal metaplasia of cardia in relationship to Helicobacter pylori infection in patients with gastro-oesophageal reflux disease and in healthy controls.
A total of 122 consecutive patients with gastro-oesophageal reflux disease and 49 control subjects were included.
During endoscopy, a total of six biopsies were taken from antrum, corpus and cardia. Helicobacter pylori infection was assessed by histology and rapid urease test. Degree of chronic gastritis, inflammatory activity and Helicobacter pylori colonization were scored from 0 to 3.
No difference in prevalence was observed between gastro-oesophageal reflux disease patients and controls as far as concerns Helicobacter pylori (41% vs 38%), inflammation of cardia (59.5% vs 70%) and intestinal metaplasia of cardia (18% vs 19%). Inflammation of cardia was significantly (p<0.001) associated with Helicobacter pylori irrespective of gastro-oesophageal reflux disease symptoms. Cardial intestinal metaplasia was more frequently (p=0.03) found in infected subjects ((27%) than in uncolonized subjects (13%). No relationship was observed between gastro-oesophageal reflux disease and carditis and cardial intestinal metaplasia. Cardial intestinal metaplasia was more frequently detected in association with carditis (26% vs 6%, p=0.001).
Inflammation and intestinal metaplasia of the gastric cardia are not markers of gastro-oesophageal reflux disease but are related to Helicobacter pylori.
幽门螺杆菌感染和/或胃食管反流病在贲门肠化生发病机制中的作用仍不清楚。
前瞻性评估胃食管反流病患者和健康对照者中，贲门炎症和肠化生的患病率与幽门螺杆菌感染的关系。
共纳入122例连续的胃食管反流病患者和49例对照者。
在内镜检查期间，从胃窦、胃体和贲门共取6块活检组织。通过组织学和快速尿素酶试验评估幽门螺杆菌感染情况。慢性胃炎程度、炎症活动度和幽门螺杆菌定植情况按0至3分进行评分。
在幽门螺杆菌感染率（41%对38%）、贲门炎症（59.5%对70%）和贲门肠化生（18%对19%）方面，胃食管反流病患者与对照者之间未观察到患病率差异。无论有无胃食管反流病症状，贲门炎症均与幽门螺杆菌显著相关（p<0.001）。感染幽门螺杆菌的受试者中贲门肠化生更为常见（27%），高于未感染的受试者（13%）（p=0.03）。未观察到胃食管反流病与贲门炎及贲门肠化生之间的关系。贲门肠化生在合并贲门炎时更常被检测到（26%对6%，p=0.001）。
胃贲门炎症和肠化生不是胃食管反流病的标志物，但与幽门螺杆菌有关。
