Yalaki Serkan, Pulat Hüseyin, Ilhan Aysu
Department of Gastroenterology, Mersin City Training and Research Hospital, Mersin, Turkey.
Department of General Surgery, Mersin City Training and Research Hospital, Mersin, Turkey.
Scand J Gastroenterol. 2020 Jan;55(1):27-33. doi: 10.1080/00365521.2019.1701071. Epub 2019 Dec 22.
Interactions between (Hp) and gastroesophageal reflux disease (GERD), which are common diseases worldwide, are confusing. In this study, the aim was to compare and evaluate the relationship between reflux esophagitis (RE) and Hp infection in adult patients with both the gastric localization of Hp and its histopathologic features. 248 patients with RE were compared with 249 age and sex matched control groups. Biopsy specimens obtained from the gastric antrum and corpus were histologically evaluated. The incidence of Hp infection was significantly lower in patients with RE than in the control group (Ratio 1.53, 95% CI 1.07-2.20; = .02, < .05). Corpus Hp colonization and corpus gastritis scores were notably lower in the study group ( = .01, < .05), whereas there was no significant difference in Hp colonization and antrum gastritis scores in the antrum. Corpus Hp colonization and gastritis scores were found to be negatively correlated with esophagitis development ( = -0.11; = .01; ( = -0.14; = .00 respectively, < .05). There was no difference between the groups in terms of atrophy development ( > .05). This study showed that the presence of Hp infection in the corpus and corpus gastritis score was significantly lower in patients with erosive reflux esophagitis than in the control group. It also showed that Hp colonization and corpus gastritis scores were negatively correlated with esophagitis development. This inverse relationship was independent of atrophy.
幽门螺杆菌(Hp)与胃食管反流病(GERD)之间的相互作用令人困惑,这两种疾病在全球都很常见。本研究旨在比较和评估成年患者反流性食管炎(RE)与Hp感染之间的关系,同时考虑Hp在胃内的定位及其组织病理学特征。将248例RE患者与249例年龄和性别匹配的对照组进行比较。对取自胃窦和胃体的活检标本进行组织学评估。RE患者中Hp感染的发生率显著低于对照组(比值1.53,95%可信区间1.07 - 2.20;P = 0.02,< 0.05)。研究组胃体Hp定植和胃体胃炎评分显著较低(P = 0.01,< 0.05),而胃窦Hp定植和胃窦胃炎评分无显著差异。发现胃体Hp定植和胃炎评分与食管炎发展呈负相关(分别为r = -0.11;P = 0.01;r = -0.14;P = 0.00,< 0.05)。两组间萎缩发展情况无差异(P > 0.05)。本研究表明,糜烂性反流性食管炎患者胃体中Hp感染的存在及胃体胃炎评分显著低于对照组。还表明Hp定植和胃体胃炎评分与食管炎发展呈负相关。这种反向关系与萎缩无关。