| 根除幽门螺旋杆菌感染对不同程度胃黏膜肠上皮化生患者病理学改变的前瞻性研究 |
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| 引用本文： | 卢光荣,何柏琪,林颖,徐昌隆,夏宣平,薛战雄,周羽翙.根除幽门螺旋杆菌感染对不同程度胃黏膜肠上皮化生患者病理学改变的前瞻性研究[J].中华全科医学,2019,17(4):571-573. |
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| 作者姓名： | 卢光荣 何柏琪 林颖 徐昌隆 夏宣平 薛战雄 周羽翙 |
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| 作者单位： | 1. 温州医科大学附属第二医院消化内科, 浙江 温州 325000; |
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| 基金项目： | 浙江省医学会临床科研基金项目(2016ZYC-A34)；温州市公益性科技计划项目(Y20170306)；温州医科大学本专科学生科研项目(wyx2017101017)；2017温州医科大学附属第二医院院内科研项目(16) |
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| 摘 要： | 目的通过对幽门螺旋杆菌(Helicobacter Pylori,H.pylori)阳性的胃黏膜肠上皮化生(intestinal metaplasia,IM)患者进行前瞻性的随访研究,明确根除H.pylori能否在一定程度上逆转IM,以及根除H.pylori对IM发生、发展的影响,为预防肠型胃癌的发生以及根除H.pylori最佳时机的选择提供一定的参考。方法收集2017年4月1日—2018年4月1日在温州医科大学附属第二医院内镜中心行胃镜检查,并经证实存在H.pylori感染和胃黏膜肠上皮化生者共280例,按照患者意愿及肠化病理轻重情况,将其分为根除H.pylori组及未根除H.pylori组(对照组),比较2组间轻、中、重度IM患者分别随访6个月及12个月的病理学改变的差异。结果随访6个月及12个月均发现,轻、中度IM患者根除H.pylori后IM程度较未根除H.pylori患者减轻(P<0.05),而重度IM患者根除H.pylori后IM程度与未根除H.pylori患者之间差异无统计学意义(P>0.05)。结论胃黏膜轻、中度IM患者若发现H.pylori感染,应尽早予以根除,此时可能为根除H.pylori的最佳时机。
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| 关 键 词： | 幽门螺旋杆菌 肠上皮化生 病理学 前瞻性研究 |
| 收稿时间： | 2018-06-12 |
A prospective study of eradication of Helicobacter pylori infection in patients with varying degrees of pathological changes in gastric mucosal intestinal metaplasia |
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| Affiliation: | Department of Gastroenterology, the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China |
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| Abstract: | Objective To determine whether eradication of H.pylori can reverse the intestinal metaplasia (IM) to a certain extent, and how the eradication of H.pylori affects IM development by a prospective follow-up study of Helicobacter pylori-positive gastric mucosal intestinal metaplasia patients, to provide some reference for prevention of intestinal type gastric cancer and determining the best time to eradication of Helicobacter pylori. Methods A total of 280 patients who were confirmed with H.pylori infection and gastric mucosal intestinal metaplasia in the endoscopy center of the Second Affiliated Hospital of Wenzhou Medical University from April 1, 2017 to April 1, 2018 were enrolled. They were divided into two groups according to the patients' wishes and the severity and distribution of intestinal pathology, and followed up for 6 and 12 months. The differences of the pathological changes of patients with mild, moderate and severe IM in two groups were compared, respectively. Results During the follow-up of 6 months and 12 months, the degree of IM after H.pylori eradication in mild to moderate IM patients was lower than that of H.pylori patients who had not received H.pylori eradication(P<0.05). However, when it came to severe IM patients, eradicating H.pylori or not showed no significant difference in degree of IM (P>0.05). Conclusion Patients with mild or moderate IM in gastric mucosa should receive Helicobacter pylori eradication therapy as soon as H.pylori is found.It may be the best time to eradicate Helicobacter pylori. |
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| Keywords: | Helicobacter pylori Intestinal metaplasia Pathology Prospective study |
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