Manes G, Dominguez-Muñoz J E, Hackelsberger A, Leodolter A, Rössner A, Malfertheiner P
Department of Gastroenterology and Pathology, University of Magdeburg, Germany.
Am J Gastroenterol. 1998 Jul;93(7):1097-100. doi: 10.1111/j.1572-0241.1998.336_b.x.
OBJECTIVE: Chronic pancreatitis is often associated with abnormal gastric acid secretion. However, previous studies have taken into consideration neither the potential role of Helicobacter pylori (H. pylori) infection nor histological features of the gastric mucosa in this context. The aim of this study was to analyze the prevalence of H. pylori infection as well as the pattern of gastritis in patients with chronic pancreatitis. METHODS: Forty patients with chronic alcoholic pancreatitis were included in the study: 40 patients with alcoholic liver cirrhosis and normal exocrine pancreatic function and 40 asymptomatic nonalcoholic subjects matched for age and sex used as control subjects. Endoscopy was performed in all patients, and five biopsy specimens from the antrum (three from the gastric body and two from the cardia) were taken for histological grading of gastritis and H. pylori assessment. RESULTS: Prevalence of H. pylori infection was similar in subjects with chronic pancreatitis (38%), asymptomatic subjects (28%) and liver cirrhosis (30%). Topography and expression of H. pylori-associated chronic gastritis was also not different among the three groups of subjects. In H. pylori-negative subjects, the presence of moderate to severe chronic antral gastritis was significantly more common in patients with chronic pancreatitis (40%) than in subjects with liver cirrhosis (18%) and in asymptomatic subjects (14%) (p < 0.05). No difference was found among the three groups of patients with regard to gastritis activity, atrophy, and intestinal metaplasia in the various gastric regions. The chronicity grade of gastritis did not correlate with the severity of pancreatic insufficiency. CONCLUSION: Prevalence of H. pylori infection is not different in patients with chronic pancreatitis as compared with subjects alcoholic liver cirrhosis and asymptomatic subjects. A severe H. pylori-negative chronic gastritis is more common in patients with chronic pancreatitis. This chronic inflammation of the gastric mucosa could contribute to determining the changes in gastric physiology described in patients with chronic pancreatitis.
目的：慢性胰腺炎常伴有胃酸分泌异常。然而，既往研究在这种情况下既未考虑幽门螺杆菌（H. pylori）感染的潜在作用，也未考虑胃黏膜的组织学特征。本研究的目的是分析慢性胰腺炎患者中H. pylori感染的患病率以及胃炎模式。 方法：40例慢性酒精性胰腺炎患者纳入本研究：40例酒精性肝硬化且外分泌胰腺功能正常的患者以及40例年龄和性别相匹配的无症状非酒精性受试者作为对照。所有患者均接受内镜检查，并从胃窦取5块活检标本（3块来自胃体，2块来自贲门）用于胃炎的组织学分级和H. pylori评估。 结果：慢性胰腺炎患者（38%）、无症状受试者（28%）和肝硬化患者（30%）中H. pylori感染的患病率相似。三组受试者中H. pylori相关性慢性胃炎部位和表达也无差异。在H. pylori阴性受试者中，中度至重度慢性胃窦炎在慢性胰腺炎患者（40%）中比在肝硬化患者（18%）和无症状受试者（14%）中更常见（p<0.05）。三组患者在不同胃区域的胃炎活动度、萎缩和肠化生方面未发现差异。胃炎的慢性程度与胰腺功能不全的严重程度无关。 结论：与酒精性肝硬化患者和无症状受试者相比，慢性胰腺炎患者中H. pylori感染的患病率无差异。严重的H. pylori阴性慢性胃炎在慢性胰腺炎患者中更常见。胃黏膜的这种慢性炎症可能有助于确定慢性胰腺炎患者中所描述的胃生理变化。
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