幽门螺杆菌感染与胃食管反流患者夜间酸突破的相关性研究

摘要

目的：研究幽门螺杆菌（Hp）感染与胃食管反流病（GERD）患者夜间酸突破（NAB）的相关性。方法选择2012年9月～2013年5月我院收治的胃食管反流病患者，使用活检胃窦组织快速尿素酶法及14C呼气试验法进行幽门螺杆菌感染监测，对监测确诊为Hp阳性的90例GERSD患者以数字法随机分为对照组45例和观察组45例。观察组进行根除Hp治疗，对照组服用泮托拉唑钠治疗。比较两组患者治疗前后的反流诊断问卷评分（RDQ）、NAB发生率以及夜间22 h至次日8 h内pH＜4.0占比情况。结果观察组患者夜间酸突破的发生率为62.2%，明显高于对照组患者的发生率35.6%，差异有统计学意义（P＜0.05）；治疗前，两组RDQ评分无明显差异（P>0.05），治疗后，观察组RDQ评分为（12.43±3.79）分，明显高于对照组的（9.21±2.93）分，差异有统计学意义（P＜0.05）。且Hp感染与NAB呈正相关（r=0.812，P＜0.05）。结论 Hp感染能在一定程度上减少NAB的发生，且Hp感染对GERD的发生和发展有着较大的保护作用。%Objective To investigate the correlation of the infection of helicobacter pylori (Hp) and nocturnal acid breakthrough (NAB) for patients with gastroesophageal reflux disease (GERD). Methods Patients with GERD who were admitted to our hospital from September 2012 to May 2013 were selected. Hp infection of the patients was tested via rapid urease tests of biopsy of gastric antrum and 14C-urea breath tests. 90 patients with GERD who were tested HP positive were randomly assigned to control group and observation group by digital method, with 45 in each group. The observation group received HP eradication, while the control group was orally administered pantoprazole sodium. Reflux diagnosis questionnaire (RDQ) scores, incidence of NAB and ratio of pH lower than 4.0 from 22 h at night till 8 h next day in the two groups before and after the treatment were compared. Results The incidence rate of NAB in observation group was 62.2%, significantly higher than that of 35.6% in control group, and the difference was statistically significant (P<0.05);There was no significant difference of RDQ scores between the two groups before the treatment (P>0.05); After the treatment, RDQ scores in observation group were (12.43 ±3.79)scores, significantly higher than that of (9.21±2.93) scores in control group, and the difference was statistically significant (P<0.05). Hp infection was positively correlated with NAB(r=0.812, P<0.05). Conclusion Hp infection has a certain effect on reducing the incidence of NAB and shows a significant protective effect on the occurrence and development of GERD.