Sugimoto Mitsushige, Murata Masaki, Iwata Eri, Nagata Naoyoshi, Itoi Takao, Kawai Takashi
Department of Gastroenterological Endoscopy, Tokyo Medical University Hospital, Shinjuku, Tokyo 160-0023, Japan.
Division of Digestive Endoscopy, Shiga University of Medical Science Hospital, Otsu 520-2192, Japan.
J Clin Med. 2021 Apr 1;10(7):1434. doi: 10.3390/jcm10071434.
A meta-analysis of reports primarily from Western countries showed no association between eradication and reflux esophagitis development. The risk of reflux esophagitis may differ among different populations based on virulence factors and acid secretion ability. We evaluated the prevalence rates of reflux esophagitis in -positive Japanese subjects and assessed risk factors for reflux esophagitis after eradication.
Among 148 -positive subjects who underwent eradication from August 2015 to December 2019, we evaluated the prevalence of reflux esophagitis on endoscopy at 12 months after eradication success and the severity of reflux-related symptoms by the F-scale questionnaire at 2 months after treatment and 12 months after eradication success.
The prevalence of reflux esophagitis in -positive patients at entry was 2.0% (3/148). At 12 months after eradication success, the prevalence was 10.8% (16/148) ( < 0.01). In the F scale, the median total score before treatment was 4 (range: 0-49), which significantly decreased to 2 (range: 0-22) ( < 0.01) at 2 months after treatment and 3 (range: 0-23) ( < 0.01) at 12 months after eradication success. Following multivariate analysis, the pretreatment total F-scale score was a risk factor for the development of reflux esophagitis (odds ratio: 1.069, 95% confidence interval: 1.003-1.139, < 0.01).
In this -positive Japanese population, eradication therapy was associated with reflux esophagitis in around 10% of patients, particularly in those with severe reflux-related symptoms at baseline. Reflux-related symptoms may improve throughout the 12 months after successful eradication therapy, irrespective of the development of reflux esophagitis.
一项主要对西方国家报告进行的荟萃分析显示，根除[幽门螺杆菌]与反流性食管炎的发生之间无关联。基于毒力因子和酸分泌能力，不同人群中反流性食管炎的风险可能有所不同。我们评估了日本幽门螺杆菌阳性受试者中反流性食管炎的患病率，并评估了根除后反流性食管炎的危险因素。
在2015年8月至2019年12月期间接受幽门螺杆菌根除治疗的148例幽门螺杆菌阳性受试者中，我们在根除成功后12个月时通过内镜检查评估反流性食管炎的患病率，并在治疗后2个月和根除成功后12个月时通过F量表问卷评估反流相关症状的严重程度。
入组时幽门螺杆菌阳性患者中反流性食管炎的患病率为2.0%（3/148）。根除成功后12个月时，患病率为10.8%（16/148）（P<0.01）。在F量表中，治疗前总评分中位数为4（范围：0 - 49），治疗后2个月时显著降至2（范围：0 - 22）（P<0.01），根除成功后12个月时降至3（范围：0 - 23）（P<0.01）。多因素分析后，治疗前F量表总评分是反流性食管炎发生的危险因素（比值比：1.069，95%置信区间：1.003 - 1.139，P<0.01）。
在这一日本幽门螺杆菌阳性人群中，根除治疗与约10%的患者发生反流性食管炎相关，尤其是那些基线时有严重反流相关症状的患者。无论反流性食管炎是否发生，成功根除治疗后的12个月内反流相关症状可能会改善。
