Department of Digestive and Liver Disease, Sant'Andrea Hospital, II School of Medicine University Sapienza of Rome, Italy.
Dig Liver Dis. 2011 Apr;43(4):295-9. doi: 10.1016/j.dld.2010.10.012. Epub 2010 Nov 27.
The effect of Helicobacter pylori treatment on the potential reversal of atrophic body gastritis (ABG) is controversial. Body atrophy reversal was evaluated in a cohort of H. pylori-negative and treated H. pylori-positive ABG patients.
Observational long-term follow-up cohort study including 300 ABG patients with at least one follow-up gastroscopy with three biopsies from the antrum and three from the body performed no earlier than 1 year after diagnosis was included. H. pylori was diagnosed by Giemsa-stain and serology. H. pylori-positive patients (n = 192) were treated with bismuth-based triple regimen.
After a mean follow-up of 5.2 years, body atrophy reversal was observed in 42/300 patients (14%). Body atrophy reversal occurred more frequently in patients treated for H. pylori than in H. pylori-negative ones (21.3% vs 0.9%, p < 0.00001) and was observed between 2 and 8 years after treatment in 52% of cases. Predictive factors for body atrophy reversal at Cox-regression analysis were mild atrophy (HR 2.14; 95% CI 1.12-4.1), moderate-severe inflammation (HR 5.3; 95% CI 1.64-17.3), and absence of intestinal metaplasia (HR 2.4; 95% CI 1.2-4.8).
Body atrophy reversal was observed in about 20% of ABG patients treated for H. pylori infection, and about 50% of reversals occurred during long-term follow-up.
幽门螺杆菌治疗对萎缩性体胃炎（ABG）潜在逆转的影响存在争议。本研究评估了一组 H. pylori 阴性和治疗后 H. pylori 阳性 ABG 患者的萎缩体逆转情况。
本研究纳入了 300 例 ABG 患者，这些患者在诊断后至少进行了一次随访胃镜检查，每次检查均在胃窦和胃体处各取 3 块活检。通过胃黏膜Giemsa 染色和血清学检测诊断 H. pylori。H. pylori 阳性患者（n=192）接受铋剂三联疗法治疗。
平均随访 5.2 年后，300 例患者中有 42 例（14%）出现胃体萎缩逆转。与 H. pylori 阴性患者相比，H. pylori 阳性患者的胃体萎缩逆转更为常见（21.3% vs 0.9%，p<0.00001），并且 52%的病例在治疗后 2-8 年内出现逆转。Cox 回归分析显示，胃体萎缩逆转的预测因素包括轻度萎缩（HR 2.14；95%CI 1.12-4.1）、中重度炎症（HR 5.3；95%CI 1.64-17.3）和无肠上皮化生（HR 2.4；95%CI 1.2-4.8）。
大约 20%的 ABG 患者经 H. pylori 感染治疗后出现胃体萎缩逆转，约 50%的逆转发生在长期随访期间。
