Nagahata Y, Azumi Y, Numata N, Yano M, Akimoto T, Saitoh Y
First Department of Surgery, Kobe University School of Medicine, Kobe, Japan.
J Gastrointest Surg. 1997 Sep-Oct;1(5):479-86. doi: 10.1016/s1091-255x(97)80137-0.
Patients with "reflux" gastritis after gastrectomy suffer from a variety of symptoms, and this type of gastritis may sometimes compromise the quality of life of these patients. Since Helicobacter pylori is considered to be one of the most important pathogenetic factors in gastritis, the association between H. pylori and reflux gastritis was investigated in this study. A total of 145 patients with gastrectomy were entered into the study. Five biopsy specimens from the gastric remnant were taken at upper gastrointestinal endoscopy. One specimen was examined pathohistologically, and the remaining four were examined for H. pylori infection. Fifty-two patients (36%) demonstrated H. pylori infection. The prevalence of H. pylori was significantly higher in patients who had a partial gastrectomy, and it was significantly lower in patients who had undergone gastrectomy more than 4 years previously. The histologic gastritis score in patients with H. pylori infection was significantly higher. Furthermore, H. pylori was eradicated in patients with some symptoms of gastritis and no bile reflux to the residual stomach at endoscopy; in these patients the symptoms were relieved and the histologic gastritis score decreased significantly. In conclusion, possible involvement of H. pylori is suspected in the pathogenesis of "nonreflux" gastritis after gastrectomy.
胃切除术后患有“反流性”胃炎的患者会出现多种症状，这种类型的胃炎有时可能会影响这些患者的生活质量。由于幽门螺杆菌被认为是胃炎最重要的致病因素之一，本研究对幽门螺杆菌与反流性胃炎之间的关联进行了调查。共有145例胃切除患者纳入本研究。在上消化道内镜检查时从胃残端取5块活检标本。1块标本进行病理组织学检查，其余4块检查幽门螺杆菌感染情况。52例患者（36%）显示有幽门螺杆菌感染。部分胃切除患者中幽门螺杆菌的患病率显著更高，而手术时间超过4年的患者中幽门螺杆菌患病率显著更低。幽门螺杆菌感染患者的组织学胃炎评分显著更高。此外，对于一些有胃炎症状且内镜检查时无胆汁反流至残胃的患者，根除幽门螺杆菌后，这些患者的症状得到缓解，组织学胃炎评分显著降低。总之，怀疑幽门螺杆菌可能参与胃切除术后“非反流性”胃炎的发病机制。
