Lipscomb G R, Wallis N, Armstrong G, Goodman M J, Rees W D
Department of Gastroenterology, Salford Hospitals NHS Trust, UK.
Dig Dis Sci. 1996 Aug;41(8):1583-8. doi: 10.1007/BF02087904.
Our objective was to determine whether H. pylori influences gastric mucosal injury and adaptation caused by naproxen. Twenty-four healthy volunteers, 12 H. pylori-positive and 12 H. pylori-negative, were given a 28-day course of naproxen 500 mg twice a day. They were each gastroscoped to assess gastric mucosal damage and mucosal blood flow before and at 1, 7, and 28 days during treatment. Maximal gastric mucosal damage (median grade + IQR) occurred during the first 24 hr in both groups and was of similar magnitude (H. pylori-positive: 2.5, 2.0-3.0 P < 0.01; H. pylori-negative: 2.0, 1.0-3.0 P < 0.01). This damage was associated with a fall in antral but not corpus mucosal blood flow. With continued NSAID administration, gastric damage resolved confirming adaptation (H. pylori-positive 1.0, 0-2.0, H. pylori-negative: 1.0, 0-1.0) and antral mucosal blood flow returned to baseline in both groups by day 28. These observations suggest that initial gastric mucosal injury is not influenced by H. pylori colonization and adaptation occurs regardless of its presence.
我们的目的是确定幽门螺杆菌是否会影响萘普生引起的胃黏膜损伤及适应性变化。24名健康志愿者，其中12名幽门螺杆菌阳性，12名幽门螺杆菌阴性，接受了为期28天的萘普生治疗，每天两次，每次500毫克。在治疗前以及治疗期间的第1天、第7天和第28天，分别对他们进行胃镜检查，以评估胃黏膜损伤和黏膜血流情况。两组在最初24小时内均出现最大胃黏膜损伤（中位数分级+四分位间距），且损伤程度相似（幽门螺杆菌阳性组：2.5，2.0 - 3.0；P < 0.01；幽门螺杆菌阴性组：2.0，1.0 - 3.0；P < 0.01）。这种损伤与胃窦黏膜血流下降有关，但与胃体黏膜血流无关。随着非甾体抗炎药的持续给药，胃损伤得到缓解，证实出现了适应性变化（幽门螺杆菌阳性组：1.0，0 - 2.0；幽门螺杆菌阴性组：1.0，0 - 1.0），到第28天两组的胃窦黏膜血流均恢复至基线水平。这些观察结果表明，初始胃黏膜损伤不受幽门螺杆菌定植的影响，无论其是否存在，适应性变化都会发生。
