Lee Yonggu, Jeon Yong Cheol, Koo Tai Yeon, Cho Hyun Seok, Byun Tae Jun, Kim Tae Yeob, Lee Hang Lak, Eun Chang Soo, Lee Oh Young, Han Dong Soo, Sohn Joo Hyun, Yoon Byung Chul
Department of Interanl Medicine, Hanyang University College of Medicine, Guri, Korea.
Korean J Gastroenterol. 2007 Nov;50(5):299-305.
BACKGROUND/AIMS: Long-term Helicobater pylori infection results in atrophic gastritis and intestinal metaplasia, and increases the risk of gastric cancer. However, it is still controversial that eradication of H. pylori improves atrophy or metaplasia. Therefore, we investigated histological changes after the H. pylori eradication in patients with atrophy or metaplasia.
One hundred seven patients who received successful eradication of H. pylori infection in Hanyang University, Guri Hospital from March 2001 to April 2006, were enrolled. Antral biopsy was taken before the eradication to confirm the H. pylori infection and grade of atrophy or metaplasia by updated Sydney System. After a certain period of time, antral biopsy was repeatedly taken to confirm the eradication and investigate histological changes of atrophy or metaplasia.
Mean age of the patients was 55.3+/-11.3, and average follow-up period was 28.7+/-13.9 months. Endoscopic diagnosis included gastric ulcer, duodenal ulcer, non-ulcer antral gastritis. Atrophy was observed in 41 of 91 and their average score was 0.73+/-0.92. After the eradication of H. pylori, atrophy was improved (0.38+/-0.70, p=0.025). However, metaplasia which was observed in 49 of 107, did not significantly improve during the follow-up period. Newly developed atrophy (7 of 38) or metaplasia (18 of 49) was observed in patients who without atrophy or metaplasia initially. Their average scores were slightly lower than those of cases with pre-existing atrophy or metaplasia without statistical significance.
After the eradication of H. pylori infection, atrophic gastritis may be improved, but change of intestinal metaplasia is milder and may take longer duration for improvement.
背景/目的：长期幽门螺杆菌感染可导致萎缩性胃炎和肠化生，并增加患胃癌的风险。然而，根除幽门螺杆菌是否能改善萎缩或化生仍存在争议。因此，我们研究了萎缩或化生患者根除幽门螺杆菌后的组织学变化。
纳入2001年3月至2006年4月在九里市汉阳大学医院成功根除幽门螺杆菌感染的107例患者。根除治疗前取胃窦活检，通过更新后的悉尼系统确认幽门螺杆菌感染情况以及萎缩或化生的程度。经过一段时间后，再次取胃窦活检以确认根除情况，并研究萎缩或化生的组织学变化。
患者的平均年龄为55.3±11.3岁，平均随访期为28.7±13.9个月。内镜诊断包括胃溃疡、十二指肠溃疡、非溃疡性胃窦炎。91例患者中有41例观察到萎缩，其平均评分为0.73±0.92。根除幽门螺杆菌后，萎缩情况有所改善（0.38±0.70，p = 0.025）。然而，107例患者中有49例观察到化生，在随访期间未显著改善。最初无萎缩或化生的患者中观察到新出现的萎缩（38例中有7例）或化生（49例中有18例）。它们的平均评分略低于原有萎缩或化生患者，但无统计学意义。
根除幽门螺杆菌感染后，萎缩性胃炎可能得到改善，但肠化生的变化较轻微，改善可能需要更长时间。
