幽门螺杆菌会加重非甾体抗炎药使用者的胃黏膜损伤吗？一项多中心、回顾性、病例对照研究。
Does Helicobacter pylori Exacerbate Gastric Mucosal Injury in Users of Nonsteroidal Anti-Inflammatory Drugs? A Multicenter, Retrospective, Case-Control Study.
作者信息
Kono Yoshiyasu, Okada Hiroyuki, Takenaka Ryuta, Miura Ko, Kanzaki Hiromitsu, Hori Keisuke, Kita Masahide, Tsuzuki Takao, Kawano Seiji, Kawahara Yoshiro, Yamamoto Kazuhide
机构信息
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Endoscopy, Okayama University Hospital, Okayama, Japan.
出版信息
Gut Liver. 2016 Jan;10(1):69-75. doi: 10.5009/gnl14372.
BACKGROUND/AIMS: The interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori remains controversial. We retrospectively investigated whether H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users.
METHODS
From January 2010 to December 2013, a total of 245 long-term NSAID (including low-dose aspirin) users who had undergone an esophagogastroduodenoscopy and had been evaluated for H. pylori infection were enrolled at Okayama University Hospital and Tsuyama Chuo Hospital. The degree of gastric mucosal injury was assessed according to the modified Lanza score (MLS). Severe gastric mucosal injury was defined as an MLS ≥4. Univariate and multivariate logistic regression analyses were performed.
RESULTS
In the univariate analysis, age ≥75 years (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.3 to 4.2), H. pylori-positivity (OR, 2.0; 95% CI, 1.2 to 3.5), and the concomitant use of proton pump inhibitors (PPIs) (OR, 0.48; 95% CI, 0.26 to 0.86) were significantly associated with severe gastric mucosal injury. The multivariate analysis was adjusted by age and sex and demonstrated that H. pylori-positivity (OR, 1.8; 95% CI, 1.0 to 3.3) and the concomitant use of PPIs (OR, 0.53; 95% CI, 0.28 to 0.99) significantly contributed to severe gastric mucosal injury.
CONCLUSIONS
H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users.
背景/目的：非甾体抗炎药（NSAIDs）与幽门螺杆菌之间的相互作用仍存在争议。我们进行了一项回顾性研究，以调查幽门螺杆菌感染是否会加重慢性NSAIDs使用者的严重胃黏膜损伤。
方法
2010年1月至2013年12月期间，冈山大学医院和津山中央医院共纳入了245名长期使用NSAIDs（包括低剂量阿司匹林）且接受过食管胃十二指肠镜检查并评估过幽门螺杆菌感染情况的患者。根据改良的兰扎评分（MLS）评估胃黏膜损伤程度。严重胃黏膜损伤定义为MLS≥4。进行了单因素和多因素逻辑回归分析。
结果
在单因素分析中，年龄≥75岁（比值比[OR]，2.4；95%置信区间[CI]，1.3至4.2）、幽门螺杆菌阳性（OR，2.0；95%CI，1.2至3.5）以及同时使用质子泵抑制剂（PPIs）（OR，0.48；95%CI，0.26至0.86）与严重胃黏膜损伤显著相关。多因素分析在调整了年龄和性别后显示，幽门螺杆菌阳性（OR，1.8；95%CI，1.0至3.3）以及同时使用PPIs（OR，0.53；95%CI，0.28至0.99）对严重胃黏膜损伤有显著影响。
结论
幽门螺杆菌感染会加重慢性NSAIDs使用者的严重胃黏膜损伤。
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