Trespi E, Broglia F, Villani L, Luinetti O, Fiocca R, Solcia E
Digestive Physiopathology Unit, IRCCS Policlinico San Matteo, Italy.
Scand J Gastroenterol. 1994 Oct;29(10):884-8. doi: 10.3109/00365529409094858.
A contribution of Helicobacter pylori gastritis to the pathogenesis of non-ulcer dyspepsia (NUD) remains uncertain.
Administration of an appropriate clinical questionnaire followed by endoscopy allowed us to select, among 139 outpatients with dyspepsia, 87 non-ulcer dyspepsia patients with more severe and group-distinctive symptoms, 35 of whom were classified as having ulcer-like (ULD). 38 as dysmotility-like (DLD), and 14 as reflux-like dyspepsia (RLD). Biopsy specimens were evaluated for H. pylori gastritis in accordance with the Sydney system. The 70 H. pylori-positive cases were treated with omeprazole, 20 mg twice daily, and amoxycillin, 1 g three times daily for 2 weeks.
Higher rates of H. pylori colonization were found histologically in the gastric mucosa of ULD (91%) and RLD (86%) than in that of DLD (68%) or asymptomatic (42%) patients. ULD differed from RLD patients in their higher score of antritis activity. Three and 6 months after H. pylori eradication ULD (but not DLD) showed significant regression of dypspetic symptoms scores.
It seems likely that H. pylori gastritis, with special reference to active antritis, is among causative factors of ULD. Its role in the pathogenesis of RLD and DLD needs further investigation.
幽门螺杆菌性胃炎对非溃疡性消化不良（NUD）发病机制的影响仍不明确。
对139例消化不良门诊患者进行适当的临床问卷调查，随后进行内镜检查，从中选出87例有更严重且具有组间特征性症状的非溃疡性消化不良患者，其中35例被归类为溃疡样（ULD），38例为动力障碍样（DLD），14例为反流样消化不良（RLD）。根据悉尼系统对活检标本进行幽门螺杆菌性胃炎评估。70例幽门螺杆菌阳性病例接受治疗，口服奥美拉唑，每日2次，每次20mg，阿莫西林，每日3次，每次1g，疗程2周。
组织学检查发现，ULD（91%）和RLD（86%）患者胃黏膜中幽门螺杆菌定植率高于DLD（68%）或无症状患者（42%）。ULD与RLD患者的区别在于其胃窦炎活动评分更高。根除幽门螺杆菌3个月和6个月后，ULD（而非DLD）患者的消化不良症状评分显著下降。
幽门螺杆菌性胃炎，特别是伴有活动性胃窦炎时，似乎是ULD的致病因素之一。其在RLD和DLD发病机制中的作用需要进一步研究。
