Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Department of Gastroenterology, Tokyo Metropolitan Police Hospital, Tokyo 164-8541, Japan.
Int J Mol Sci. 2019 Apr 18;20(8):1913. doi: 10.3390/ijms20081913.
() eradication therapy may improve gastric atrophy and intestinal metaplasia, but the results of previous studies have not always been consistent. The aim of this study was to compare the histological changes of intestinal metaplasia and gastric atrophy among the use of acid-suppressing drugs after eradication.
A cohort of 242 patients who underwent successful eradication therapy for . gastritis and surveillance endoscopy examination from 1996 to 2015 was analyzed. Changes in the histological scores of intestinal metaplasia and atrophy according to drug use (proton-pump inhibitors (PPIs), H receptor antagonists (H2RAs), and non-acid suppressant use) were evaluated in biopsies of the antrum and corpus using a generalized linear mixed model in all patients.
The mean follow-up period and number of biopsies were 5.48 ± 4.69 years and 2.62 ± 1.67 times, respectively. Improvement in the atrophy scores of both the antrum ( = 0.042) and corpus ( = 0.020) were significantly superior in patients with non-acid suppressant drug use compared with those of PPI and H2RA use. Metaplasia scores in both the antrum and corpus did not improve in all groups, and no significant differences were observed among groups in the antrum ( = 0.271) and corpus ( = 0.077).
Prolonged acid suppression by PPIs or H2RAs may limit the recovery of gastric atrophy following eradication.
（）根除疗法可能改善胃萎缩和肠化生，但先前的研究结果并不总是一致。本研究旨在比较（）根除后使用抑酸药物对肠化生和胃萎缩的组织学变化。
分析了 1996 年至 2015 年期间因（）胃炎接受成功根除治疗和监测内镜检查的 242 例患者。使用广义线性混合模型评估所有患者胃窦和胃体活检中根据药物使用（质子泵抑制剂（PPIs）、H2 受体拮抗剂（H2RAs）和非酸抑制药物）改变肠化生和萎缩组织学评分的情况。
平均随访时间和活检次数分别为 5.48±4.69 年和 2.62±1.67 次。与 PPI 和 H2RA 相比，非酸抑制药物组患者胃窦（ =0.042）和胃体（ =0.020）的萎缩评分改善明显更好。所有组的化生评分均未改善，各组间胃窦（ =0.271）和胃体（ =0.077）无显著差异。
PPIs 或 H2RAs 的长期酸抑制可能限制（）根除后胃萎缩的恢复。
