Does Helicobacter pylori Exacerbate Gastric Mucosal Injury in Users of Nonsteroidal Anti-Inflammatory Drugs? A Multicenter, Retrospective, Case-Control Study.
Does Helicobacter pylori Exacerbate Gastric Mucosal Injury in Users of Nonsteroidal Anti-Inflammatory Drugs? A Multicenter, Retrospective, Case-Control Study.
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DOI：
10.5009/gnl14372
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发表时间：
2016-01
期刊：
影响因子：
3.4
通讯作者：
Yamamoto K
中科院分区：
文献类型：
--
作者：
Kono Y;Okada H;Takenaka R;Miura K;Kanzaki H;Hori K;Kita M;Tsuzuki T;Kawano S;Kawahara Y;Yamamoto K
非甾体抗炎药（NSAID）和幽门螺杆菌之间的相互作用仍然存在争议。我们回顾性地调查了H.幽门螺杆菌感染加重了慢性NSAID使用者的严重胃粘膜损伤。从2010年1月至2013年12月，共有245名长期NSAID（包括低剂量阿司匹林）使用者接受了食管胃镜检查，并进行了H. pylori感染者在冈山大学医院和津山中央医院入组。采用改良Lanza评分（MLS）评价胃黏膜损伤程度。重度胃粘膜损伤定义为MLS ≥4。进行单因素和多因素Logistic回归分析。在单因素分析中，年龄≥75岁（比值比[OR]，2.4; 95%置信区间[CI]，1.3 - 4.2），H.幽门螺杆菌阳性（OR，2.0; 95% CI，1.2 - 3.5）和伴随使用质子泵抑制剂（PPI）（OR，0.48; 95% CI，0.26 - 0.86）与重度胃粘膜损伤显著相关。多因素分析经年龄和性别调整后，显示H。幽门螺杆菌阳性（OR，1.8; 95% CI，1.0 - 3.3）和伴随使用PPI（OR，0.53; 95% CI，0.28 - 0.99）显著导致重度胃粘膜损伤。H.幽门螺杆菌感染加重了慢性NSAID使用者的严重胃粘膜损伤。
The interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori remains controversial. We retrospectively investigated whether H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users. From January 2010 to December 2013, a total of 245 long-term NSAID (including low-dose aspirin) users who had undergone an esophagogastroduodenoscopy and had been evaluated for H. pylori infection were enrolled at Okayama University Hospital and Tsuyama Chuo Hospital. The degree of gastric mucosal injury was assessed according to the modified Lanza score (MLS). Severe gastric mucosal injury was defined as an MLS ≥4. Univariate and multivariate logistic regression analyses were performed. In the univariate analysis, age ≥75 years (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.3 to 4.2), H. pylori-positivity (OR, 2.0; 95% CI, 1.2 to 3.5), and the concomitant use of proton pump inhibitors (PPIs) (OR, 0.48; 95% CI, 0.26 to 0.86) were significantly associated with severe gastric mucosal injury. The multivariate analysis was adjusted by age and sex and demonstrated that H. pylori-positivity (OR, 1.8; 95% CI, 1.0 to 3.3) and the concomitant use of PPIs (OR, 0.53; 95% CI, 0.28 to 0.99) significantly contributed to severe gastric mucosal injury. H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users.