关键词: 胆汁反流性胃炎, 幽门螺杆菌, 胃粘膜病变, 胃镜下分级, 病理学分级

Abstract: Objective To investigate the prevalence of Helicobacter pylori （Hp） infection and gastric mucosa inflammation in patients with bile reflux gastritis（BRG）. Methods 618 patients with BRG and 1486 patients with chronic superficial gastritis（CSG） without bile reflux were recruited in our hospital between March 2015 and February 2017. Gastroscopy was carried out in all patients,and the Hp infection was determined by ¹⁴C-urea breath test,serum anti-Hp antibody detection and gastric mucosa histopathological examination. Results The prevalence of Hp infection was 32.7%（202/618） in patients with BRG,no significant difference as compared to 40.6% （603/1486） in patients with CSG （P>0.05）;the mild,moderate and severe inflammatory reaction of gastric mucosa in 202 BRG patients with Hp positive were 10.9%,61.4% and 27.7%,much severer than 40.4%,51.7% and 7.9% （P<0.05） in 416 patients with Hp negative,and the incidences of lymphoid follicle formation,intestinal metaplasia and active inflammation were 15.4%,5.4% and 16.8%,respectively,also much severer than 2.7%,10.8% and 0.7%（P<0.05） in patients with Hp negative;the mild,moderate and severe inflammatory reaction of gastric mucosa in 603 CSG patients with Hp positive were 29.2,59.4% and 11.5%,no significant difference as compared to 34.1%,54.0% and 11.9%,respectively （P>0.05） in 883 patients with Hp negative,and the incidences of lymphoid follicle formation,intestinal metaplasia and active inflammation were 10.4%,1.8% and 8.5%,also no significant difference as compared to 7.8%,1.0% and 5.0%,respectively（P>0.05） in patients with Hp negative;the pathological examination of gastric mucosa showed that the severity of inflammation in 117 BRG patients with III degree of gastric mucosal lesions under gastroscopy were more severe than in 200 patients with I degree or 301 patients with II degree （P<0.05）. Conclusion The gastric lesions under gastroscopy and histopathological inflammation of gastric mucosa are obvious in patients with BRG and bile reflux and Hp infection are the important factors in the pathogenesis of gastric mucosa inflammation. The endoscopic classification has a significant implication in early judgment of the disease.

Key words: Bile reflux gastritis, Helicobacter pylori, Gastric mucosa, Endoscopy, Pathology