Kawakita N, Nagahata Y, Azumi Y, Wada T, Numata N, Saitoh Y
First Department of Surgery, Kobe University School of Medicine.
Nihon Shokakibyo Gakkai Zasshi. 1995 May;92(5):862-9.
Residual gastritis after gastrectomy brings the various symptoms such as abdominal pain, nausea, emesis and loss of appetite, and often hazards quality of life of the patient. Bile reflux to the stomach is believed as one of the important pathogenesis of residual gastritis, however the prevention for bile reflux cannot always heal the gastritis. Helicobacter pylori (H. pylori) is considered as one of the most important pathogenesis of gastroduodenal ulcer and gastritis, and H. pylori may possibly cause residual gastritis after gastrectomy. However, the association between infection with H. pylori and the residual gastritis has not revealed yet. In the present study, the association with H. pylori and the residual gastritis after gastrectomy was investigated in 56 patients who had undergone gastrectomy before. Twenty-four patients (42.9%) had H. pylori infection at their stomachs and the incidence of the infection in the patients with gastrectomy was significantly higher with subtotal gastrectomy. As for the histological gastritis score of Rauws (Rauws' score), Rauws' score of H. pylori positive group was significantly higher than H. pylori negative group. Furthermore, the eradication of H. pylori for the patients with serious symptoms of gastritis improved the symptoms and decreased significantly Rauws' score. These results suggest that H. pylori was associated with the pathogenesis of residual gastritis after gastrectomy.
胃切除术后残留性胃炎会引发腹痛、恶心、呕吐及食欲不振等多种症状，常常危害患者的生活质量。胆汁反流至胃被认为是残留性胃炎的重要发病机制之一，然而预防胆汁反流并不能总是治愈胃炎。幽门螺杆菌（H. pylori）被视作胃十二指肠溃疡和胃炎最重要的发病机制之一，幽门螺杆菌可能会导致胃切除术后残留性胃炎。然而，幽门螺杆菌感染与残留性胃炎之间的关联尚未明确。在本研究中，对56例既往接受过胃切除术的患者进行了幽门螺杆菌与胃切除术后残留性胃炎之间关联的调查。24例患者（42.9%）胃部存在幽门螺杆菌感染，胃切除患者中该感染发生率在胃次全切除术中显著更高。至于Rauws组织学胃炎评分（Rauws评分），幽门螺杆菌阳性组的Rauws评分显著高于幽门螺杆菌阴性组。此外，对有严重胃炎症状的患者根除幽门螺杆菌可改善症状并使Rauws评分显著降低。这些结果表明，幽门螺杆菌与胃切除术后残留性胃炎的发病机制有关。
