Gasbarrini A, Massari I, Serricchio M, Tondi P, De Luca A, Franceschi F, Ojetti V, Dal Lago A, Flore R, Santoliquido A, Gasbarrini G, Pola P
Internal Medicine Department, Catholic University, Rome, Italy.
Dig Dis Sci. 1998 Aug;43(8):1641-5. doi: 10.1023/a:1018842527111.
Raynaud's phenomenon is defined by an intermittent vasospasm of the arterioles of the distal limbs. Helicobacter pylori infection has been recently associated with Raynaud's phenomenon. The aim of this study was to assess the effects of H. pylori eradication on Raynaud's attacks. Forty-six patients affected by primary Raynaud's phenomenon were evaluated. H. pylori infection was assessed by [13C]urea breath test. Eradication therapy was given to infected patients for seven days. Discomfort and the duration and frequency of attacks of Raynaud's phenomenon per week were assessed. Thirty-six subjects were infected with H. pylori; the bacterium was eradicated in 83% of these after therapy. Attacks of Raynaud's phenomenon completely disappeared in 17% of the patients with H. pylori eradication. Discomfort and the duration and frequency of attacks of Raynaud's phenomenon were significantly reduced in 72% of the remaining patients. Conversely, attacks of Raynaud's disease did not change significantly during the 12-week follow-up period either in the H. pylori-negative patients or in the infected subjects in whom the bacterium was not eradicated by therapy. The study shows that H. pylori eradication causes a significant decrease in clinical attacks of Raynaud's disease. The reduction of vasoactive substances determined by the eradication of the bacterium may be the pathogenetic mechanism underlying the phenomenon.
雷诺现象的定义是远端肢体小动脉的间歇性血管痉挛。幽门螺杆菌感染最近被认为与雷诺现象有关。本研究的目的是评估根除幽门螺杆菌对雷诺发作的影响。对46例原发性雷诺现象患者进行了评估。通过[13C]尿素呼气试验评估幽门螺杆菌感染情况。对感染患者给予7天的根除治疗。评估不适以及每周雷诺现象发作的持续时间和频率。36名受试者感染了幽门螺杆菌;治疗后其中83%的患者细菌被根除。根除幽门螺杆菌的患者中17%的雷诺现象发作完全消失。其余72%的患者不适以及雷诺现象发作的持续时间和频率显著降低。相反,在12周的随访期内,幽门螺杆菌阴性患者或治疗后细菌未被根除的感染受试者中,雷诺病发作均无显著变化。该研究表明,根除幽门螺杆菌可使雷诺病的临床发作显著减少。根除细菌所导致的血管活性物质减少可能是这一现象的发病机制。