Does Helicobacter Pylori Infection Play a Role in the pathogenesis of Non-Ulcer Dyspepsia - A Study of Gastric Emptying Time

幽門螺旋桿菌感染在非潰瘍性消化不良中之致病角色－胃排空機能之探討

蘇育正(Yu-Chung Su) ； 詹昌明(Chang-Ming Jan) ； 王文明(Wen-Ming Wang) ； 陳立宗(Li-Tzong Chen) ； 吳登強(Deng-Chyang Wu) ； 劉景勳(Chiang-Shin Liu) ； 鍾相彬(Shiang-Bing Jong) ； 胡淑惠(Shu-Hui Hu) ； 陳章義(Chang Yi Chan)

《The Kaohsiung Journal of Medical Sciences》 11卷1期 (1995/01) Pp. 8-14

https://doi.org/10.6452/KJMS.199501.0008

摘要

為了探討幽門螺旋桿菌（Helicobacter pylori，簡稱H. pylori）感染是否與非潰瘍性消不良（Non-Ulcer Dyspesia，簡稱NUD）病人之臨床症狀與胃排空機能不良有所相關？我們從82年2月至11月對於10位健康人（男5位，女5位，年齡平均46.9歲）及28位NUD病人（H. Pylori陽性15位，H. Pylori陰性13位，年齡平均39.4歲）實施胃內視檢查；並以中式炒飯作為標準測試食物，應用核醫方法測定固相胃排空時間。同時對NUD病人之上腹不適症狀予記錄並積分。H. Pylori陽性之患者有8位接受根除H. Pylori之治療（服用口服colloid bismuth subcitrate 120 mg q i d, tertracyclin 500 mg q i d及metronidazole 250 mg q i d共14天）。7位經證實H. Pylori已根除之病患再接受胃排空時間測定及臨床症狀調查，結果顯示：（1）胃半排空時間（t1/2）與H. Pylori有無沒有關連（H. Pylori陽性：190.86±112.53分，H. Pylori陰性：227.69±179.29分）；（2）H. Pylori感染之有無與臨床症狀之嚴重程度無關（總症狀積分：H. Pylori陽性者：10.07±3.84，H. Pylori陰性者：7.62±2.25）；（3）胃半排空時間（t1/2）與上復症狀之嚴重程度無相關；（4）H. Pylori陽組有胃排空間延遲者佔46.7%（7/15），H. Pylori陰性者佔30.8%（4/13），兩者無統計學上有意義之差異；（5）H. Pylori根除者其胃排空時間前後並無差異（前：171.14±128.13分；後：158.57±182.49分），但症狀總積分有所改善（前：9.28±2.75；後：3.85±4.22）（P=0.0277）。

並列摘要

To investigate the relationship between gastric motility and Helicobacter pylori infection in patients with non-ulcer dyspepsia, 28 and 10 asymptomatic healthy persons underwent gastroduodenal endoscope examinations and scintigraphic test of solid phase gastric emptying time using Chinese fried rice as a test meal. Clinical symptoms were also recorded using questionnaires for scoring. Half emptying times for ingested food (t1/2) between H. pylori infected (190.86±112.53 minutes) and uninfected patients (227.69±179.29 minutes) were not different statistically. Seven of the 15 patients with H. pylori infection (46.6%) had delayed gastric emptying time t1/2＞197.7 minutes), compared to 4 out of 13 without infection (30.07%)(p＞0.05). There was also no association between the status of H. pylori infection and severity of clinical symptoms (total symptoms scores: H. pylori positive: 10.07±3.84; H. pylori negative: 7.62±2.25)(p＞0.05). Seven patients for whom H. pylori was found to have been eradicated using triple therapy (colloid bismuth subcitrate 120 mg q i d, tetracycline 500 mg q i d and metronidazole 250 mg q i d for 14 days) did not show significant changes in gastric emptying time (before: 171.14±128.13; after: 158.57±182.49 minutes) but showed improvement in total symptoms scores (before: 9.28±3.85; after 3.85±4.22) (p=0.0277). Conclusions: infection by H. pylori in patients with non-ulcer dyspepsia did not influence solid phase of gastric emptying time and was not associated with clinical symptoms. Eradication of H. pylori infection relieved the clinical symptoms of the patients with non-ulcer dyspepsia. The causes of improvement were not due to changes of solid phase gastric emptying time.

並列關鍵字

Helicobacter pylori ； non-ulcer dyspepsia ； gastric emptying time