Santarelli Luca, Gabrielli Maurizio, Santoliquido Angelo, Cuoco Lucio, Cazzato Alessia, Candelli Marcello, Celestino Nista Enrico, De Lorenzo Antonino, Gentiloni Silveri Nicolò, Pola Paolo, Gasbarrini Giovanni, Gasbarrini Antonio
Department of Internal Medicine, Catholic University the Sacred Heart, Rome, Italy.
Scand J Gastroenterol. 2006 May;41(5):532-5. doi: 10.1080/00365520500349549.
Helicobacter pylori infection is the major agent of gastric damage. Coeliac disease may affect the morphology and function of the entire gastrointestinal tract from the stomach to the colon. The aim of this study was to assess the gastric histological pattern in patients with H. pylori and untreated coeliac disease.
We retrospectively enrolled 183 H. pylori-positive patients with (85, group A) and without (98, group B) untreated coeliac disease. The groups were similar for age, gender and smoking habit, and all the patients came from the same geographical area. Histological evaluation of gastric pattern was performed on 4 biopsies (2 in the antrum, 2 in the corpus). Gastric damage was classified according to the modified Sydney System. Diagnosis of H. pylori infection was based on positivity to histology. The chi-square test was used to assess differences between groups. A p-value <0.05 was considered significant.
Group A showed a significantly higher prevalence of follicular gastritis than group B (23.5% versus 12.2%, p=0.045). A significantly lower prevalence of atrophic gastritis was observed in group A compared with that in group B (6% versus 22.5%, p=0.002). The prevalence of chronic superficial gastritis, activity degree and intestinal metaplasia was similar between the two groups.
In patients with H. pylori infection, untreated coeliac disease could represent a risk factor for follicular gastritis and is associated with a lower prevalence of atrophic gastritis. The complex interaction between H. pylori and untreated coeliac disease on Th-1/Th-2 balance in the gastric mucosa could explain these results.
幽门螺杆菌感染是胃损伤的主要因素。乳糜泻可能会影响从胃到结肠的整个胃肠道的形态和功能。本研究的目的是评估幽门螺杆菌感染且未经治疗的乳糜泻患者的胃组织学模式。
我们回顾性纳入了183例幽门螺杆菌阳性患者，其中85例（A组）患有未经治疗的乳糜泻，98例（B组）未患未经治疗的乳糜泻。两组在年龄、性别和吸烟习惯方面相似，所有患者均来自同一地理区域。对4块活检组织（胃窦2块，胃体2块）进行胃组织学模式的评估。胃损伤根据改良的悉尼系统进行分类。幽门螺杆菌感染的诊断基于组织学阳性。采用卡方检验评估组间差异。p值<0.05被认为具有统计学意义。
A组滤泡性胃炎的患病率显著高于B组（23.5%对12.2%，p=0.045）。与B组相比，A组萎缩性胃炎的患病率显著更低（6%对22.5%，p=0.002）。两组之间慢性浅表性胃炎的患病率、活动程度和肠化生情况相似。
在幽门螺杆菌感染患者中，未经治疗的乳糜泻可能是滤泡性胃炎的一个危险因素，且与萎缩性胃炎的较低患病率相关。幽门螺杆菌与未经治疗的乳糜泻在胃黏膜Th-1/Th-2平衡上的复杂相互作用可以解释这些结果。
