Fukuchi Takumi, Ashida Kiyoshi, Yamashita Hiroshi, Kiyota Naomi, Tsukamoto Reiko, Takahashi Hajime, Ito Dai, Nagamatsu Ryousuke
Department of Gastroenterology and Hepatology, Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka 530-0012, Japan.
J Gastroenterol. 2005 Apr;40(4):350-60. doi: 10.1007/s00535-004-1552-1.
Whether or not the eradication of Helicobacter pylori is a risk factor for reflux esophagitis (RE) is a question at issue. To find an answer, it is necessary to clarify the influence of H. pylori eradication on the mechanism of RE.
The authors investigated the influence of H. pylori eradication on gastric acidity and gastroesophageal reflux in ten gastric ulcer (GU) patients and ten duodenal ulcer (DU) patients by 24-h simultaneous determination of pH in the stomach and esophagus.
Though the results indicated enhanced gastric acidity in GU patients at night after H. pylori eradication, no such influence was observed in DU patients. No significant changes in gastroesophageal reflux occurred in GU or DU patients before and after H. pylori eradication. RE after H. pylori eradication occurred in only one patient, with GU. This patient had several risk factors for RE, such as obesity, male sex, and dietary habits to add to the increase in gastric acidity at night that occurred after H. pylori eradication. No increase in gastroesophageal reflux occurred in any DU patients or in the other GU patients that demonstrated enhanced gastric acidity at night after H. pylori eradication.
The cure of H. pylori infection does not, by itself, cause RE in patients who have few other risk factors for RE.
幽门螺杆菌根除是否为反流性食管炎（RE）的危险因素仍存在争议。为找到答案，有必要阐明幽门螺杆菌根除对RE发病机制的影响。
作者通过对10例胃溃疡（GU）患者和10例十二指肠溃疡（DU）患者同时进行24小时胃和食管pH值测定，研究幽门螺杆菌根除对胃酸度和胃食管反流的影响。
虽然结果显示幽门螺杆菌根除后GU患者夜间胃酸度增强，但DU患者未观察到此类影响。幽门螺杆菌根除前后，GU或DU患者的胃食管反流均无显著变化。幽门螺杆菌根除后仅1例GU患者发生RE。该患者存在多种RE危险因素，如肥胖、男性及饮食习惯等，加之幽门螺杆菌根除后夜间胃酸度增加。在任何DU患者或其他幽门螺杆菌根除后夜间胃酸度增强的GU患者中，均未出现胃食管反流增加的情况。
对于其他RE危险因素较少的患者，幽门螺杆菌感染的治愈本身不会导致RE。
