Feng Gui-jian, Hu Fu-lian, Wang Hua-hong, Liu Jian-xiang
Department of Gastroenterology, First Hospital of PeKing University, Beijing 100034, China.
Zhonghua Yi Xue Za Zhi. 2003 Jan 25;83(2):96-9.
To study the relationship of Helicobacter pylori, lower esophageal sphincter pressure and gastrin in gastroesophageal reflux disease, to evaluate the effect of Helicobacter pylori on gastroesophageal reflux disease.
20 patients were underwent 24-hour ambulatory esophageal pH monitoring to confirm the diagnosis of gastroesophageal reflux disease, and their lower esophageal sphincter pressure was measured by esophageal manometry. The patients were diagnosed endoscope negative GERD and endoscope positive GERD by endoscopy, and 3 biopsy specimens obtained from the gastric antrum at the same time were used for Helicobacter pylori culture, rapid urease test and Warthin-Starry stain. Hp infection was affirmed when at least two of the three tests were positive, then the patients were divided into Hp-negative group and Hp-positive group. Fasting serum gastrin concentration was determined by radioimmunoassay in 13 patients.
Hp-positive patients were 8 (male 4, endoscope negative GERD 2, mean age 55 +/- 9), Hp-negative patients were 12 (male 10, endoscope negative GERD 3, mean age 55 +/- 10). 13 of these patients were performed fasting serum gastrin measurement. The mean lower esophageal sphincter pressure, gastrin concentration and 24-hour pH monitoring DeMeester score in Hp-positive patients group were 11.25 mm Hg, 87.437 pg/ml and 72.30 respectively, and those in Hp-negative patients group were 13.75 mm Hg, 88.725 pg/ml and 55.64. Between the two groups, there was no significant difference in LESP, gastrin and DeMeester score (P = 0.193, P = 0.932 and P = 0.479); There was no correlation between LESP and gastrin, while serum gastrin level is associated strongly with DeMeester score (r = 0.902, P < 0.01).
The study showed that Helicobacter pylori had no effect on LESP by gastrin, however serum fasting gastrin concentration and DeMeester score were associated with each other.
研究幽门螺杆菌、食管下括约肌压力和胃泌素在胃食管反流病中的关系,评估幽门螺杆菌对胃食管反流病的影响。
对20例患者进行24小时动态食管pH监测以确诊胃食管反流病,并用食管测压法测量其食管下括约肌压力。通过内镜检查将患者诊断为内镜阴性胃食管反流病和内镜阳性胃食管反流病,同时从胃窦获取3份活检标本用于幽门螺杆菌培养、快速尿素酶试验和沃辛-斯塔里染色。当三项检测中至少两项呈阳性时确定为幽门螺杆菌感染,然后将患者分为幽门螺杆菌阴性组和幽门螺杆菌阳性组。对13例患者采用放射免疫分析法测定空腹血清胃泌素浓度。
幽门螺杆菌阳性患者8例(男性4例,内镜阴性胃食管反流病2例,平均年龄55±9岁),幽门螺杆菌阴性患者12例(男性10例,内镜阴性胃食管反流病3例,平均年龄55±10岁)。其中13例患者进行了空腹血清胃泌素测定。幽门螺杆菌阳性患者组的平均食管下括约肌压力、胃泌素浓度和24小时pH监测的DeMeester评分分别为11.25mmHg、87.437pg/ml和72.30,幽门螺杆菌阴性患者组分别为13.75mmHg、88.725pg/ml和55.64。两组之间,食管下括约肌压力、胃泌素和DeMeester评分无显著差异(P = 0.193、P = 0.932和P = 0.479);食管下括约肌压力与胃泌素之间无相关性,而血清胃泌素水平与DeMeester评分密切相关(r = 0.902,P < 0.01)。
研究表明幽门螺杆菌不会通过胃泌素对食管下括约肌压力产生影响,然而血清空腹胃泌素浓度与DeMeester评分相互关联。