Tucci A, Poli L, Tosetti C, Biasco G, Grigioni W, Varoli O, Mazzoni C, Paparo G F, Stanghellini V, Caletti G
Institute of Medical Clinic & Gastroenterology, Department of Pathology, Hospital S. Orsola-Malpighi, University of Bologna, Italy.
Am J Gastroenterol. 1998 Sep;93(9):1425-31. doi: 10.1111/j.1572-0241.1998.00454.x.
We sought to evaluate the effect of Helicobacter pylori eradication in patients with fundic atrophic gastritis.
Acid secretion, gastric emptying, and histology were evaluated in 20 patients with fundic atrophic gastritis and H. pylori infection. After investigation, 10 patients (Group 1) received an eradicating treatment and 10 (Group 2) did not receive any treatment. One year later, the baseline investigations were repeated. Subsequently, patients in Group 2 received the same treatment given to patients in Group 1 and were reevaluated 12 months later. A further follow-up was performed in both groups 36 months after the treatment.
At 1-yr follow-up, all the patients in Group 1 were H. pylori negative whereas all the patients in Group 2 were still infected. In Group 1, there was a significant improvement of both fundic atrophy and acid secretion, compared with baseline (p < 0.01). In Group 2, no substantial modification of either histological or functional parameters was observed at the first follow-up; conversely, a significant (p < 0.01) improvement of fundic atrophy and acid secretion was detected in these patients 12 months after eradication of the bacterium. Histological pattern remained unchanged at 36 months of follow-up in both groups. Gastric emptying remained, on the average, unaffected by the treatment; however, three patients with delayed gastric emptying at entry had normal gastric emptying after eradication of H. pylori.
Our data suggest that mucosal atrophy can be reduced or even reversed by the eradication of H. pylori, and this is associated with a recovery of gastric function.
我们试图评估根除幽门螺杆菌对胃底萎缩性胃炎患者的影响。
对20例胃底萎缩性胃炎合并幽门螺杆菌感染的患者进行胃酸分泌、胃排空及组织学评估。检查后，10例患者（第1组）接受根除治疗，10例患者（第2组）未接受任何治疗。1年后，重复进行基线检查。随后，第2组患者接受与第1组相同的治疗，并在12个月后重新评估。治疗36个月后对两组患者进行进一步随访。
在1年的随访中，第1组所有患者幽门螺杆菌检测均为阴性，而第2组所有患者仍有感染。与基线相比，第1组胃底萎缩和胃酸分泌均有显著改善（p<0.01）。在第1次随访时，第2组患者的组织学或功能参数均无明显改变；相反，在根除幽门螺杆菌12个月后，这些患者的胃底萎缩和胃酸分泌有显著改善（p<0.01）。两组在随访36个月时组织学模式均未改变。平均而言，胃排空不受治疗影响；然而，3例初诊时胃排空延迟的患者在根除幽门螺杆菌后胃排空恢复正常。
我们的数据表明，根除幽门螺杆菌可减轻甚至逆转黏膜萎缩，且这与胃功能的恢复有关。
