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中华胃食管反流病电子杂志

中华胃食管反流病电子杂志 ›› 2024, Vol. 11 ›› Issue (02) : 95 -99. doi: 10.3877/cma.j.issn.2095-8765.2024.02.006

论著

不同类型幽门螺杆菌合并反流性食管炎的临床病理特征分析
蒋琦1, 刘卫东1, 艾合买江·库尔班江1, 惠文佳1, 张梦霞1, 李紫琼1, 高峰1,†()   
  1. 1. 830001　乌鲁木齐，新疆维吾尔自治区人民医院消化内科；830001　乌鲁木齐，新疆维吾尔自治区人民医院新疆消化系统疾病临床医学研究中心
  • 收稿日期:2024-02-19 出版日期:2024-05-15
  • 通信作者: 高峰
  • 基金资助:
    新疆维吾尔自治区人民医院院内项目(20230107); 中央引导地方科技发展专项(ZYYD2022A06)

Clinical and pathological characteristics analysis of reflux esophagitis combined with different types of Helicobacter pylori

Qi Jiang1, Weidong Liu1, Kuerbanjiang Aihemaijiang·1, Wenjia Hui1, Mengxia Zhang1, Zi Qiong Li1, Feng Gao1,†()   

  1. 1. Department of Gastroenterology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China; Xinjiang Clinical Research Center for Digestive Diseases, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China
  • Received:2024-02-19 Published:2024-05-15
  • Corresponding author: Feng Gao
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引用本文：

蒋琦, 刘卫东, 艾合买江·库尔班江, 惠文佳, 张梦霞, 李紫琼, 高峰. 不同类型幽门螺杆菌合并反流性食管炎的临床病理特征分析[J]. 中华胃食管反流病电子杂志, 2024, 11(02): 95-99.

Qi Jiang, Weidong Liu, Kuerbanjiang Aihemaijiang·, Wenjia Hui, Mengxia Zhang, Zi Qiong Li, Feng Gao. Clinical and pathological characteristics analysis of reflux esophagitis combined with different types of Helicobacter pylori[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2024, 11(02): 95-99.

目的

探讨分析不同类型幽门螺杆菌（Hp）感染合并反流性食管炎（RE）临床症状、疾病严重程度及血清胃功能指标的相关性。

方法

纳入2021年5月至2023年5月新疆维吾尔自治区人民医院确诊反流性食管炎患者580例为研究对象。按Hp抗体分型测定分为Ⅰ型Hp感染组、Ⅱ型Hp感染组和阴性组，分析各组间的临床资料和血清学指标。

结果

RE患者的Hp感染率为20.35%。Ⅰ型Hp感染组的典型和非典型临床症状均高于Ⅱ型Hp感染组（P均<0.05)；Ⅰ型Hp感染组病理严重程度高于Ⅱ型Hp感染组和阴性组，差异有统计学意义（P均<0.05)；Ⅰ型Hp感染组与Ⅱ型Hp感染组和阴性组比较，血清胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ、胃蛋白酶原比值比和胃泌素17水平均增高，差异有统计学意义（P均<0.05)。

结论

RE患者Hp感染率较低，不同类型Hp现症感染对RE疾病的发展存在差异。

关键词: 反流性食管炎, 幽门螺杆菌, 毒力因子, 血清胃功能检测
Objective

To explore the correlation analysis of clinical symptoms, disease severity and serum gastric function indicators of different types of Helicobacter pylori (Hp) infection combined with reflux esophagitis (RE).

Methods

A total of 580 patients diagnosed with reflux esophagitis in People's Hospital of Xinjiang Uygur Autonomous Region from May 2021 to May 2023 were enrolled as the study subjects. According to the Hp antibody typing test, they were divided into type Ⅰ Hp infection group, type Ⅱ Hp infection group and negative group, and the clinical data and serological indicators of each group were analyzed.

Results

The Hp infection rate in RE patients was 20.35%. The typical and atypical clinical symptoms of typeⅠ Hp infection group were higher than those of typeⅡ Hp infection group (P<0.05); the pathological severity of typeⅠ Hp infection group was higher than that of typeⅡ Hp infection group and negative group, and the difference was statistically significant (P<0.05); compared with type Ⅱ Hp infection group and negative group, the serum levels of PGⅠ, PGⅡ, PGR and G-17 in typeⅠ Hp infection group were increased, and the difference was statistically significant (P<0.05).

Conclusion

The Hp infection rate in RE patients is low, and different types of Hp symptomatic infection have different effects on the development of RE disease.

Key words: Reflux esophagitis, Helicobacter pylori, Virulence factors, Serum gastric function test
表1 倾向性评分匹配前后患者基线资料比较
组别 n 倾向性评分匹配前 倾向性评分匹配后
年龄[岁，M(Q1，Q3)] 性别[例(%)] 年龄[岁，M(Q1，Q3)] 性别[例(%)]
男性 女性 男性 女性
Ⅰ型Hp组 123 57(50, 65) 86(69.92) 37(30.08) 58(50, 65) 79(69.91) 34(30.09)
Ⅱ型Hp组 133 57(50, 64) 91(68.42) 42(31.58) 55(48.5, 64) 74(70.48) 31(29.52)
阴性组 388 60(52, 67) 269(69.33) 119(30.67) 59(51, 67) 252(69.61) 110(30.39)
χ2/Z   7.45 0.07 5.47 0.03
P值   0.024 0.966 0.065 0.985
表2 不同组间反流性食管炎患者临床症状比较[n（%）]
  n 典型症状 非典型症状
Ⅰ型Hp组 113 55(48.67)* 70(61.95)*
Ⅱ型Hp组 105 34(32.38) 48(45.71)#
阴性组 362 143(39.50) 207(57.18)
χ2   6.12 6.34
P   0.047 0.042
表3 不同组间反流性食管炎患者病理分级比较[例（%）]
组别 例数 A级 B级 C级 D级
Ⅰ型Hp组 113 57(50.44) *# 40(35.40) *# 10(8.85) *# 6(5.31) *#
Ⅱ型Hp组 105 74(70.48) 18(17.14) 8(7.62) 5(4.76)
阴性组 362 252(69.61) 72(19.89) 32(8.84) 6(1.66)
χ2值   21.020
P值   0.001
表4 不同组间反流性食管炎患者血清学活检指标比较[M(Q1，Q3)]
组别 例数 胃蛋白酶原Ⅰ 胃蛋白酶原Ⅱ 胃蛋白酶原Ⅰ/Ⅱ 胃泌素-17
Ⅰ型Hp组 113 201.91(156.42, 254.36)*# 12.77(7.35, 18.90)*# 15.09(10.78, 27.91)*# 3.91(1.83, 6.70)*#
Ⅱ型Hp组 105 181.33(133.36, 224.73) 9.51(4.37, 13.55) 18.13(14.31, 32.46) 1.29(1.07, 2.73)
阴性组 362 191.55(146.63, 230.67) 9.789(5.08, 15.33) 18.27(14.04, 29.91) 1.31(1.03, 2.85)
Ζ值   8.960 14.010 9.280 61.380
P值   0.011 0.001 0.010 0.000
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