Werdmuller B F, van der Putten A B, Loffeld R J
Department of Internal Medicine, Ziekenhuis De Heel, Zaandam, The Netherlands.
Neth J Med. 1998 Oct;53(4):164-7. doi: 10.1016/s0300-2977(98)00022-9.
A retrospective study was done in consecutive patients in order to seek out whether dyspepsia subgroups (reflux-like, ulcer-like, and, dysmotility-like dyspepsia) can be useful in describing Helicobacter pylori positive and negative functional dyspepsia.
Consecutive patients who underwent upper gastrointestinal endoscopy were included if no macroscopic lesions in oesophagus, stomach or duodenum were seen. Antral biopsy specimens were taken for detection of H. pylori. A validated questionnaire was used.
Six hundred patients fulfilled the inclusion criteria. Three hundred were positive for H. pylori. In the H. pylori positive (HP+) patients only 3 (1.2%) had 'pure' reflux-like dyspepsia, 17 (6.9%) had ulcer-like dyspepsia and 10 (4%) suffered from dysmotility-like dyspepsia. In the H. pylori negative (HP-) patients these figures were 6 (2.3%), 17 (6.6%) and 7 (2.7%), respectively (ns). The majority of patients had a combination of complaints belonging to the three subgroups. Reflux-like dyspepsia was present in 179 (73%) HP+ dyspeptics and 195 (76%) HP-'s (ns). Ulcer-like dyspepsia was present in 213 (88%) HP+ cases and 233 (92%) HP-'s (ns). Dysmotility-like dyspepsia was present in 197 (81%) HP+'s and 212 (82%) HP-'s (ns).
It is concluded that it is not possible to identify patients suffering from H. pylori infection on basis of symptom clusters.
对连续的患者进行了一项回顾性研究,以探寻消化不良亚组(反流样、溃疡样和动力障碍样消化不良)是否有助于描述幽门螺杆菌阳性和阴性功能性消化不良。
纳入接受上消化道内镜检查且食管、胃或十二指肠未见宏观病变的连续患者。采集胃窦活检标本检测幽门螺杆菌。使用经过验证的问卷。
600名患者符合纳入标准。300名幽门螺杆菌检测呈阳性。在幽门螺杆菌阳性(HP+)患者中,仅3例(1.2%)有“单纯”反流样消化不良,17例(6.9%)有溃疡样消化不良,10例(4%)有动力障碍样消化不良。在幽门螺杆菌阴性(HP-)患者中,这些数字分别为6例(2.3%)、17例(6.6%)和7例(2.7%)(无显著性差异)。大多数患者有属于这三个亚组的多种症状组合。反流样消化不良在179例(73%)HP+消化不良患者和195例(76%)HP-患者中出现(无显著性差异)。溃疡样消化不良在213例(88%)HP+病例和233例(92%)HP-患者中出现(无显著性差异)。动力障碍样消化不良在197例(81%)HP+患者和212例(82%)HP-患者中出现(无显著性差异)。
得出的结论是,不可能根据症状群来识别幽门螺杆菌感染患者。