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[幽门螺杆菌根除治疗后反流性食管炎的发生]

[Development of reflux esophagitis after H. pylori eradication therapy].

作者信息

Kamada Tomoari, Haruma Ken, Inoue Kazuhiko, Takao Toshihiro, Shiotani Akiko

出版信息

Nihon Rinsho. 2016 Aug;74(8):1328-1333.

Abstract

Several studies showed that H. pylori infection is significantly lower in reflux esophagitis (RE) patients than in elder asymptomatic controls in Japan. It is well known that H. pylori infection induces corporal atrophic gastritis, and suppresses gastric acid secretion. In the other words, H. pylori infection shows a negative association with the development of RE. The relative lack of corpus gastritis might play a role in the pathogenesis of RE through preservation of the acid secretion area. Meanwhile, the occurrence of RE after H. pylori eradication was first report;e' in Europe in 1997. However, no consensus has been reached on whether H. pylori eradication leads to the onset of a de-novo RE. Eradication of H. pylori infection may be a risk factor for de-novo RE, especially in Asian populations. The presence of hiatal hernia and corpus gas- tritis are closely related to the development of RE after H. pylori eradication. RE, which develops after H. pylori eradication, rarely becomes a long-term clinical problem among patients who complete therapy successfully.

摘要

多项研究表明,在日本,反流性食管炎(RE)患者的幽门螺杆菌感染率显著低于老年无症状对照者。众所周知,幽门螺杆菌感染会引发胃体萎缩性胃炎,并抑制胃酸分泌。换句话说,幽门螺杆菌感染与RE的发生呈负相关。胃体胃炎相对缺乏可能通过保留胃酸分泌区域在RE的发病机制中起作用。同时,1997年欧洲首次报道了幽门螺杆菌根除后发生RE的情况。然而,对于幽门螺杆菌根除是否会导致新发RE,尚未达成共识。根除幽门螺杆菌感染可能是新发RE的一个危险因素,尤其是在亚洲人群中。食管裂孔疝和胃体胃炎的存在与幽门螺杆菌根除后RE的发生密切相关。在成功完成治疗的患者中,幽门螺杆菌根除后发生的RE很少成为长期临床问题。

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