摘要
目的探讨叶酸联合幽门螺杆菌根除治疗慢性萎缩性胃炎(CAG)患者疾病进展和黏膜转归的影响因素。方法回顾163例CAG患者(CAG组)及160例非CAG患者(非CAG组)的临床资料,分析影响CAG进展的相关因素。CAG组患者中幽门螺杆菌阳性128例,其中63例采用标准三联幽门螺杆菌根除治疗(对照组),65例采用叶酸联合三联幽门螺杆菌根除治疗(研究组),比较两组患者临床疗效及黏膜转归情况。结果多因素Logistic回归分析结果显示,患者年龄、幽门螺杆菌感染、胆汁反流、胃癌家族史与CAG进展密切相关(P<0.05)。研究组患者临床总有效率高于对照组(93.85%vs.82.54%)(P<0.05)。研究组治疗后黏膜炎性反应、活动性、萎缩、肠上皮化生和异型增生等各项胃镜病理评分均低于对照组,胃泌素浓度高于对照组(P<0.05)。结论幽门螺杆菌感染、高龄、胆汁反流和胃癌家族史是影响CAG进展的相关因素。采用叶酸联合幽门螺杆菌根除治疗有助于改善CAG患者的转归。
Objective To investigate the factors influencing disease progression and mucosal outcome in patients with chronic atrophic gastritis (CAG)treated with folic acid combined with Helicobacter pylori eradication.Methods Clinical data of 163patients with CAG (group CAG)and 160patients with non-CAG patients (group non-CAG)were reviewed and the factors affecting the progression of CAG in group CAG were analyzed.Among 163CAG patients,Helicobacter pylori was positive in 128patients,of whom 63cases were treated with standard triple Helicobacter pylori eradication (group A)and 65were treated with folic acid combined with triple Helicobacter pylori eradication (group B).The clinical efficacy and mucosal outcomes of the two groups were compared. Results Multivariate Logistic regression analysis showed that age,Helicobacter pylori infection,bile reflux and family history of gastric cancer were closely associated with the disease progression of CAG (P<0.05).The overall clinical effectiveness rate of group B was higher than that of group A (93.85% vs.82.54%)(P<0.05).The pathological scores of mucosal inflammatory reaction, activity,atrophy,intestinal metaplasia and dysplasia were lower,but gastrin concentration was higher, in group B than those in group A (P<0.05).Conclusion Helicobacter pylori infection,advanced age,bile reflux and family history of gastric cancer are the related factors influencing the disease progression of CAG.Folic acid combined with Helicobacter pylori eradication treatment can improve the outcomes of the patients with CAG.
作者
吴玉秋
刘洪明
柴霞
WU Yuqiu;LIU Hongming;CHAI Xia(Department of Internal Medicine,Tianjin First Hospital,Tianjin 300242,CHINA)
出处
《江苏医药》
CAS
2018年第11期1283-1286,共4页
Jiangsu Medical Journal
基金
天津市卫计委科研立项项目(2017086)
关键词
慢性萎缩性胃炎
叶酸
幽门螺杆菌
Chronic atrophic gastritis
Folic acid
Helicobacter pylori
