Grande Michele, Cadeddu Federica, Villa Massimo, Attinà Grazia Maria, Muzi Marco Gallinella, Nigro Casimiro, Rulli Francesco, Farinon Attilio M
Department of Surgery, University Hospital Tor Vergata, Rome, Italy.
World J Surg Oncol. 2008 Jul 5;6:74. doi: 10.1186/1477-7819-6-74.
The nature of the relationship between Helicobacter pylori and reflux oesophagitis is still not clear. To investigate the correlation between Helicobacter pylori infection and GERD taking into account endoscopic, pH-metric and histopathological data.
Between January 2001 and January 2003 a prospective study was performed in 146 patients with GERD in order to determine the prevalence of Helicobacter pylori infection at gastric mucosa; further the value of the De Meester score endoscopic, manometric and pH-metric parameters, i.e. reflux episodes, pathological reflux episodes and extent of oesophageal acid exposure, of the patients with and without Helicobacter pylori infection were studied and statistically compared. Finally, univariate analysis of the above mentioned data were performed in order to evaluate the statistical correlation with reflux esophagitis.
There were no statistically significant differences between the two groups, HP infected and HP negative patients, regarding age, gender and type of symptoms. There was no statistical difference between the two groups regarding severity of symptoms and manometric parameters. The value of the De Meester score and the ph-metric parameters were similar in both groups. On univariate analysis, we observed that hiatal hernia (p = 0,01), LES size (p = 0,05), oesophageal wave length (p = 0,01) and pathological reflux number (p = 0,05) were significantly related to the presence of reflux oesophagitis.
Based on these findings, it seems that there is no significant evidence for an important role for H. pylori infection in the development of GERD and erosive esophagitis. Nevertheless, current data do not provide sufficient evidence to define the relationship between HP and GERD. Further assessments in prospective large studies are warranted.
幽门螺杆菌与反流性食管炎之间关系的本质仍不清楚。考虑到内镜、pH值监测和组织病理学数据，研究幽门螺杆菌感染与胃食管反流病（GERD）之间的相关性。
在2001年1月至2003年1月期间，对146例GERD患者进行了一项前瞻性研究，以确定胃黏膜幽门螺杆菌感染的患病率；此外，研究并统计比较了幽门螺杆菌感染患者和未感染患者的De Meester评分、内镜、测压和pH值监测参数，即反流发作次数、病理性反流发作次数和食管酸暴露程度。最后，对上述数据进行单因素分析，以评估与反流性食管炎的统计相关性。
在年龄、性别和症状类型方面，幽门螺杆菌感染组和未感染组之间没有统计学上的显著差异。两组在症状严重程度和测压参数方面没有统计学差异。两组的De Meester评分和pH值监测参数值相似。单因素分析显示，食管裂孔疝（p = 0.01）、下食管括约肌（LES）大小（p = 0.05）、食管波长（p = 0.01）和病理性反流次数（p = 0.05）与反流性食管炎的存在显著相关。
基于这些发现，似乎没有显著证据表明幽门螺杆菌感染在GERD和糜烂性食管炎发生中起重要作用。然而，目前的数据不足以确定幽门螺杆菌与GERD之间的关系。有必要在前瞻性大型研究中进行进一步评估。
