Chen Li-Wei, Chang Liang-Che, Hua Chung-Ching, Hsieh Bor-Jen, Chen Shuo-Wei, Chien Rong-Nan
Departments of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan.
Departments of Pathology, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan.
BMC Gastroenterol. 2017 Jan 3;17(1):1. doi: 10.1186/s12876-016-0563-8.
Gastric epithelial hyper-proliferation was reported in patients with Helicobacter pylori (H. pylori)-infected gastric mucosa with intestinal metaplasia (IM) changes. In patients with gastric ulcer (GU) and IM, the GU may have a different healing rate in comparison to patients without IM. This study aimed to compare the difference in GU healing between H. pylori-infected patients with IM and those without IM.
We retrospectively analyzed patients at the Keelung Chung Gung Memorial Hospital during the period from March 2005 to January 2011. The inclusion criteria were: 1) endoscopic findings of GU and biopsy histological examination plus rapid urease test indicating H. pylori infection; 2) gastric IM adjacent to a GU but with no atrophic gastritis changes; 3) patients receiving H. pylori eradication triple therapy and 8 weeks of maintenance therapy with a proton pump inhibitor; and 4) patients receiving follow-up endoscopy within the 3 and the 4 months after treatment.
In total, 327 patients with GU and H. pylori infection (136 with IM and 191 without IM) were included. Patients with IM had a higher GU healing rate than those without IM (91.9% vs. 84.3%, P = 0.040). Multivariate logistical regression analysis revealed that failure of H. pylori eradication (Odds = 4.013, 95% CI: 1.840-8.951, P < 0.001) and gastric IM (Odds = 0.369, 95% CI: 0.168-0.812, P = 0.013) were the predictors of non-healing GU following treatment.
Patient with gastric IM change may have a higher GU healing rate than those without gastric IM. However, successful H. pylori eradication is a more important factor for GU healing than gastric IM.
据报道，幽门螺杆菌（H. pylori）感染且胃黏膜有肠化生（IM）改变的患者存在胃上皮细胞过度增殖。在患有胃溃疡（GU）和IM的患者中，与没有IM的患者相比，GU的愈合率可能有所不同。本研究旨在比较H. pylori感染的IM患者和无IM患者之间GU愈合的差异。
我们回顾性分析了2005年3月至2011年1月期间基隆中光纪念医院的患者。纳入标准为：1）胃镜检查发现GU且活检组织学检查加快速尿素酶试验表明H. pylori感染；2）GU附近有胃IM但无萎缩性胃炎改变；3）接受H. pylori根除三联疗法及质子泵抑制剂8周维持治疗的患者；4）治疗后3个月和4个月内接受随访胃镜检查的患者。
总共纳入了327例GU和H. pylori感染患者（136例有IM，191例无IM）。有IM的患者GU愈合率高于无IM的患者（91.9%对84.3%，P = 0.040）。多因素logistic回归分析显示，H. pylori根除失败（比值 = 4.013，95%可信区间：1.840 - 8.951，P < 0.001）和胃IM（比值 = 0.369，95%可信区间：0.168 - 0.812，P = 0.013）是治疗后GU未愈合的预测因素。
有胃IM改变的患者GU愈合率可能高于无胃IM的患者。然而，成功根除H. pylori对GU愈合比胃IM更重要。
