幽門螺桿菌（Hp）感染與胃食管反流病的關系分析

李菁

[摘要] 目的 探討幽門螺桿菌（Hp）感染與胃食管反流病的關系。 方法 選擇本院2014年1月～2016年1月收治的胃食管反流病患者30例，其中正常5例、A級6例、B級9例、C級6例、D級4例，另外選擇同期我院消化科經胃鏡檢查確診的慢性胃炎伴糜爛患者30例，比較GERD組與胃炎組的Hp感染率以及不同分級GERD患者Hp感染率。 結果 GERD組Hp感染率20.0%，胃炎組Hp感染率60.0%，兩組比較差異有統計學意義（P<0.05）。GERD組中，正常級別患者的Hp感染率20.0%、A級患者的Hp感染率16.7%、B級患者的Hp感染率11.1%、C級患者的Hp感染率16.7%、D級患者的Hp感染率50.0%、不同分級GERD患者Hp感染率組間比較，差異不顯著（P>0.05）。結論 幽門螺桿菌（Hp）感染與胃食管反流病具有一定的相關性，Hp感染可能對GERD的發生可能起到一定的保護作用。但由于樣本數較少，因此，仍需擴大樣本數對Hp感染與GERD關系進行進一步研究，從而為胃食管反流病的臨床治療起到指導性作用。

[關鍵詞] 胃食管反流病；幽門螺桿菌；感染；分級

[中圖分類號] R573.9 [文獻標識碼] B [文章編號] 1673-9701（2017）13-0082-03

[Abstract] Objective To investigate and analyze the relationship between helicobacter pylori （Hp） infection and gastroesophageal reflux disease. Methods 30 patients with gastroesophageal reflux disease who were admitted to our hospital from January 2014 to January 2016 were selected. There were 5 cases of normal， 6 cases of grade A， 5 cases of grade B， 6 cases of grade C， and 8 cases of grade D. In addition， 30 patients with chronic gastritis with erosion diagnosed by endoscopy in the Department of Gastroenterology in our hospital during the same period of time were selected. The Hp infection rate was compared between the GERD group and the gastritis group， and the Hp infection rate in the GERD patients with different grades was compared. Results The infection rate of Hp was 20.0% in GERD group and 60.0% in gastritis group，there was significant difference between the two groups（P<0.05）. In the GERD group， the Hp infection rate was 20.0% in normal patients， the Hp infection rate was 16.7% in the grade A patients， 11.1% in the grade B patients， 16.7% in the grade C patients， and 50.0% in the grade D patients. There was no significant difference in the Hp infection rate among different groups of GERD patients with different grades（P>0.05）. Conclusion Helicobacter pylori （Hp） infection has a certain correlation with gastroesophageal reflux disease， and Hp infection may have a protective effect on the occurrence of GERD. However， due to the small number of samples， the number of samples should be expanded and further study on the relationship between Hp infection and GERD should be carried out， so as to provide a guiding significance for the clinical treatment of gastroesophageal reflux disease.

[Key words] Gastroesophageal reflux disease； Helicobacter pylori （Hp）； Infection； Grading

幽門螺桿菌（helicobacterpylori，Hp）是一種從胃黏膜中分離出來的致病菌，研究發現，Hp感染與消化性潰瘍、胃癌等胃部疾病具有顯著的相關性[1-2]。胃食管反流?。╣astroesophageal reflux disease，GERD）是一種常見的胃腸動力障礙性疾病，是指食管黏膜異常地暴露于胃內容物所導致的疾病[3]，包括內鏡陰性的胃食管反流、反流性食管炎、Barrett食管及其他并發癥，目前其病因、發病機制尚不明確。近年來研究發現，隨著Hp感染率的逐漸下降，GERD和食管腺癌的發病率明顯上升[4]。且有研究發現，幽門螺桿菌感染可能影響食管下括約肌的壓力、局部胃酸分泌以及胃排空功能[5]，但目前臨床關于幽門螺桿菌感染與GERD的相關性報道不一，幽門螺桿菌感染與GERD的相關性研究成為目前臨床研究的熱點。……