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类风湿关节炎患者胃肠损害与幽门螺杆菌感染的相关性研究 |
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刘湘源 施桂英
【摘 要】 目的 探讨Hp在类风湿关节炎(RA)患者胃肠损害中可能发挥的作用。方法 以16例强直性脊柱炎(AS)及11例特发性消化道溃疡(PUD)患者为对照，对46例RA患者进行胃镜检查，并采集胃窦粘膜组织进行Warthin-Starry银染色及PCR扩增法，同时应用ELISA法测定患者血清抗Hp-IgG抗体水平，综合判定Hp感染状态。统计RA患者Hp感染与胃镜下改变及临床指标的相关性。并对RA患者作胃肠道溃疡的危险因素分析。结果 RA组的Hp感染率明显低于PUD组(P＜0.05)，而与AS组间无明显差异(分别为45.65%、90.91%和37.3%)。RA组中，Hp感染者发生消化道溃疡的比例明显高于无Hp感染者(分别为33.33%和8%，P＜0.05)，RA患者发生溃疡的主要危险因素为年龄＞60岁(RR＝10.33，P＜0.01)、长期不间断服用NSAIDs(＞1年)(RR＝16.67，P＜0.05)及Hp感染(RR＝5.75，P＜0.05)，尤其是以上三种因素同时存在时，发生消化道溃疡的危险性显著增高(RR＝35，P＜0.001)。结论 Hp感染参与了RA患者胃肠溃疡的发生，Hp可能与NSAIDs一道，具有协同致消化道溃疡作用。
【关键词】 螺杆菌，幽门 关节炎，类风湿 胃肠疾病
Roles of Helicobacter pylori infection in the induction of gastrointestinal lesions of RA patients
LIU Xiangyuan,SHI Guiying.General Hospital of PLA,Beijing,100853
【Abstract】 Objective To explore the possible role of Helicobacter pylori (Hp) in the induction of gastroduodenal tract′s lesions of rheumatoid arthritis (RA) patients.Methods After gastric endoscopy was performed on the patients with 46 RA,16 ankylosing spondylitis (AS) and 11 peptic ulcer disease (PUD),Hp infection was synthetically identified by the PCR assay,Warthin-Starry silver staining for antral mucosa and serologic anti-Hp IgG antibody test (ELISA).Association of Hp infection with endoscopic and clinical findings was analyzed.The main risk factors that predispose RA patients to the development of peptic ulcer were also analyzed.Results The rate of infection by Hp in RA patients significantly lower than that in patients with PUD (P＜0.05),whereas the rate between patients with RA and AS was not significantly different (P＞0.05).In RA group,the prevalence of peptic ulcer was significantly higher in Hp positive patients than that in Hp negative ones (P＜0.05)。The main risk factors that predispose RA patients to the development of peptic ulcer included the persistent use of NSAIDs (＞one year) (RR＝16.67,P＜0.05),the age of more than 60 (RR＝10.33,P＜0.01) and Hp infection ([1] [2] 下一页
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