University of Virginia Health System, Charlottesville, VA 22908-0708 , USA.
J Clin Gastroenterol. 2010 Mar;44(3):180-5. doi: 10.1097/MCG.0b013e3181ac9830.
Although Helicobacter pylori infection is believed to be the main cause of chronic gastritis, a US clinical trial investigating the long-term effects of lansoprazole as maintenance therapy for erosive esophagitis revealed a surprisingly high prevalence (over 90%) and severity of chronic gastritis in H. pylori-negative subjects.
This study aims to compare prevalence and severity of chronic gastritis of the body and antrum in H. pylori-negative subjects with erosive esophagitis, nonerosive reflux disease, or functional dyspepsia from several trials.
Pretreatment gastric histology was compared in 1595 H. pylori-negative subjects with erosive esophagitis (>or= grade 2; n=196), nonerosive reflux disease (n=688), or functional dyspepsia (n=711) who participated in US Takeda-sponsored lansoprazole trials.
Pretreatment histology data from US clinical studies showed that 67.5% and 75.0% of H. pylori-negative adult subjects with erosive esophagitis had moderate or severe body and antral chronic gastritis, respectively. Chronic gastritis was also observed in H. pylori-negative subjects with nonerosive reflux disease or functional dyspepsia, although prevalence was significantly less (P<0.001) than in erosive esophagitis.
Chronic gastritis in H. pylori-negative subjects is more common than previously appreciated. These results highlight the need for better characterization of gastric mucosal histology in these gastrointestinal disorders.
尽管人们认为幽门螺杆菌感染是慢性胃炎的主要病因，但一项针对质子泵抑制剂兰索拉唑用于糜烂性食管炎维持治疗的长期疗效的美国临床试验显示，在幽门螺杆菌阴性患者中，慢性胃炎的发生率（超过 90%）和严重程度均出人意料地高。
本研究旨在比较几项试验中幽门螺杆菌阴性的糜烂性食管炎、非糜烂性反流病和功能性消化不良患者的胃体和胃窦慢性炎症的发生率和严重程度。
对比了参加美国武田制药公司赞助的兰索拉唑试验的 1595 例幽门螺杆菌阴性的糜烂性食管炎（≥2 级；n=196）、非糜烂性反流病（n=688）或功能性消化不良（n=711）患者的治疗前胃组织学。
来自美国临床研究的预处理组织学数据显示，67.5%和 75.0%的幽门螺杆菌阴性的糜烂性食管炎成人患者分别存在中重度胃体和胃窦慢性炎症。在幽门螺杆菌阴性的非糜烂性反流病或功能性消化不良患者中也观察到了慢性炎症，但发生率明显较低（P<0.001）。
幽门螺杆菌阴性患者的慢性炎症比之前认为的更为常见。这些结果强调了在这些胃肠道疾病中更好地描述胃黏膜组织学特征的必要性。
