Wu J C Y, Chan F K L, Wong S K H, Lee Y T, Leung W K, Sung J J Y
Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
Aliment Pharmacol Ther. 2002 Mar;16(3):545-52. doi: 10.1046/j.1365-2036.2002.01189.x.
The effect of Helicobacter pylori eradication on reflux oesophagitis is unclear.
To study the effect of H. pylori eradication on oesophageal acid exposure and disease severity in patients with reflux oesophagitis.
Patients with reflux oesophagitis and H. pylori infection were recruited for 24-h oesophageal pH-metry. They were then randomly assigned to receive either treatment for H. pylori eradication (1-week omeprazole-based triple therapy, followed by 7-week omeprazole) or omeprazole alone (8-week omeprazole). Uninfected patients were recruited as controls. Endoscopy, pH monitoring and symptom assessment were repeated at 26 weeks.
Forty patients (25 H. pylori-positive and 15 uninfected) with erosive oesophagitis were studied. Fourteen were randomized to receive treatment for H. pylori eradication and 11 to receive omeprazole alone. There was no difference in the percentage of time the oesophageal pH < 4 before and 26 weeks after treatment among the three groups. However, the percentage of time the oesophageal pH < 2 (P=0.01) and pH < 3 (P=0.02) was significantly increased in patients receiving treatment for H. pylori eradication. Three (21%) patients in the group receiving treatment for H. pylori eradication had worsening of reflux oesophagitis.
H. pylori eradication increases oesophageal acid exposure and may adversely affect the clinical course of reflux disease in a subset of patients.
幽门螺杆菌根除对反流性食管炎的影响尚不清楚。
研究幽门螺杆菌根除对反流性食管炎患者食管酸暴露及疾病严重程度的影响。
招募反流性食管炎合并幽门螺杆菌感染的患者进行24小时食管pH监测。然后将他们随机分为两组，一组接受幽门螺杆菌根除治疗（基于奥美拉唑的三联疗法1周，随后服用奥美拉唑7周），另一组仅接受奥美拉唑治疗（服用奥美拉唑8周）。招募未感染患者作为对照。在26周时重复进行内镜检查、pH监测和症状评估。
研究了40例糜烂性食管炎患者（25例幽门螺杆菌阳性，15例未感染）。14例随机接受幽门螺杆菌根除治疗，11例仅接受奥美拉唑治疗。三组治疗前和治疗26周后食管pH<4的时间百分比无差异。然而，接受幽门螺杆菌根除治疗的患者食管pH<2（P=0.01）和pH<3（P=0.02）的时间百分比显著增加。接受幽门螺杆菌根除治疗的组中有3例（21%）患者反流性食管炎病情恶化。
幽门螺杆菌根除会增加食管酸暴露，可能对部分患者的反流性疾病临床病程产生不利影响。
