Analyzing the influence of gastric intestinal metaplasia on gastric ulcer healing in Helicobacter pylori–infected patients without atrophic gastritis

BMC Gastroenterology

Research Article

Bor-Jen Hsieh¹  Li-Wei Chen¹  Shuo-Wei Chen¹  Rong-Nan Chien¹  Chung-Ching Hua²  Liang-Che Chang³ 

[1] Departments of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan;Departments of Internal Medicine, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan;Departments of Pathology, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan;

关键词: Helicobacter pylori;    Intestinal metaplasia;    Peptic ulcer;   

DOI  :  10.1186/s12876-016-0563-8

 received in 2016-07-12, accepted in 2016-12-16,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundGastric epithelial hyper-proliferation was reported in patients with Helicobacter pylori (H. pylori)–infected gastric mucosa with intestinal metaplasia (IM) changes. In patients with gastric ulcer (GU) and IM, the GU may have a different healing rate in comparison to patients without IM. This study aimed to compare the difference in GU healing between H. pylori–infected patients with IM and those without IM.MethodsWe retrospectively analyzed patients at the Keelung Chung Gung Memorial Hospital during the period from March 2005 to January 2011. The inclusion criteria were: 1) endoscopic findings of GU and biopsy histological examination plus rapid urease test indicating H. pylori infection; 2) gastric IM adjacent to a GU but with no atrophic gastritis changes; 3) patients receiving H. pylori eradication triple therapy and 8 weeks of maintenance therapy with a proton pump inhibitor; and 4) patients receiving follow-up endoscopy within the 3rd and the 4th months after treatment.ResultsIn total, 327 patients with GU and H. pylori infection (136 with IM and 191 without IM) were included. Patients with IM had a higher GU healing rate than those without IM (91.9% vs. 84.3%, P = 0.040). Multivariate logistical regression analysis revealed that failure of H. pylori eradication (Odds = 4.013, 95% CI: 1.840–8.951, P < 0.001) and gastric IM (Odds = 0.369, 95% CI: 0.168–0.812, P = 0.013) were the predictors of non-healing GU following treatment.ConclusionsPatient with gastric IM change may have a higher GU healing rate than those without gastric IM. However, successful H. pylori eradication is a more important factor for GU healing than gastric IM.

【 授权许可】

CC BY   
© The Author(s). 2017