Berstad A, Alexander B, Weberg R, Serck-Hanssen A, Holland S, Hirschowitz B I
Division of Gastroenterology, University of Alabama at Birmingham.
Gastroenterology. 1988 Sep;95(3):619-24. doi: 10.1016/s0016-5085(88)80006-4.
Antral biopsy specimens from 89 consecutive patients with nonulcer dyspepsia and erosive prepyloric changes included in a prospective, randomized, double-blind 4-wk study of the effect of an aluminum-magnesium antacid (120 mmol/day) or pirenzepine (50 mg b.i.d.) vs. placebo were examined histologically. Campylobacter pylori (CP) was found by light microscopy of silver-stained sections in 25 patients (28%). Campylobacter pylori-positive patients were on average older than CP-negative patients (p = 0.02). There was a strong association between CP colonization and acute inflammation (p less than 0.001), both being rare in the absence of chronic inflammation. During treatment with antacids, the density of CP decreased (p less than 0.001) without any improvement of the inflammatory reaction. On the contrary, the number of patients with gastritis tended to increase after antacids as compared with placebo (p less than 0.10). A separate analysis showed no symptomatic effect of the drugs. Thus, neither nonulcer dyspepsia nor erosive prepyloric changes are strongly associated with antral CP colonization or acute inflammation. Aluminum-magnesium antacids may suppress antral CP infection without healing the gastritis or relieving symptoms.
对89例连续性非溃疡性消化不良和幽门管糜烂性病变患者的胃窦活检标本进行了组织学检查。这些患者被纳入一项前瞻性、随机、双盲的4周研究，该研究旨在比较铝镁抗酸剂（120 mmol/天）或哌仑西平（50 mg，每日两次）与安慰剂的疗效。通过银染切片的光学显微镜检查，在25例患者（28%）中发现了幽门螺杆菌（CP）。幽门螺杆菌阳性患者的平均年龄高于CP阴性患者（p = 0.02）。CP定植与急性炎症之间存在很强的关联（p < 0.001），在没有慢性炎症的情况下，两者都很少见。在使用抗酸剂治疗期间，CP的密度降低（p < 0.001），但炎症反应没有任何改善。相反，与安慰剂相比，使用抗酸剂后胃炎患者的数量有增加的趋势（p < 0.10）。单独的分析显示这些药物没有症状改善作用。因此，非溃疡性消化不良和幽门管糜烂性病变与胃窦CP定植或急性炎症均无强烈关联。铝镁抗酸剂可能会抑制胃窦CP感染，但无法治愈胃炎或缓解症状。
