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研究生:蔡淑惠
研究生(外文):Shwu-Huey Tsai
論文名稱:幽門螺旋桿菌感染對逆流性食道炎病患胃酸分泌及食道蠕動功能之影響
論文名稱(外文):Effect of Helicobacter pylori infection on intragastric acidity and esophageal motility in reflux esophagitis
指導教授:陳 全 木張 繼 森
指導教授(外文):Chuan-Mu ChenChi-Sen Chang
學位類別:碩士
校院名稱:國立中興大學
系所名稱:生命科學院碩士在職專班
學門:生命科學學門
學類:生物學類
論文種類:學術論文
論文出版年:2003
畢業學年度:91
語文別:中文
論文頁數:64
中文關鍵詞:逆流性食道炎幽門螺旋桿菌胃酸分泌食道蠕動
外文關鍵詞:reflux esophagitisHelicobacter pyloriintragastric acidityesophageal motility
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過去十年來,幽門螺旋桿菌的感染與胃食道逆流疾病的關係,一直是消化系醫學的熱門話題之一。有些研究指出,感染幽門螺旋桿菌的病患,得到胃食道逆流疾病的機率較少,但是流行病學卻顯示相反關係。胃食道逆流疾病是由於食道過度曝露在酸性的環境下,所引起的疾病,引起此症狀的主要因素,包括下食道括約肌鬆弛,食道對酸的清除力受損,以及食道粘膜的自我保護功能衰弱。食道體的蠕動,是對抗逆流機轉中重要的因素,食道蠕動功能喪失,會導致酸性物質延長滯留於食道,而且會增加食道粘膜的損傷程度。逆流性食道炎在已開發的國家普遍有很高的盛行率,在瑞士有11.7%,美國有15.7%,英國有22.8%,在台灣並不如以往所認為的少見,有逐年增加的趨勢。本研究的目的,是探討感染幽門螺旋桿菌對逆流性食道炎病人的影響。研究的對象來自台中榮民總醫院,包括50位未感染幽門螺旋桿菌的逆流性食道炎的病人,以及50位有感染幽門螺旋桿菌的逆流性食道炎的病人,評估其食道蠕動功能,及24小時胃酸分泌之酸鹼值變化。結果發現,感染幽門螺旋桿菌與未感染幽門螺旋桿菌之兩種逆流性食道炎病患族群,在年齡,性別,及體脂肪指數上並無統計上之顯著差異。大部份的病人食道炎為輕度。24小時胃酸偵測之研究中,發現有感染幽門螺旋桿菌的病人比没有感染幽門螺旋桿菌的病人,其胃酸分泌較少;兩組的下食道括約肌基礎壓力則相近。在食道蠕動功能異常方面,亦無明顯差異。所以,基於本研究結果發現,幽門螺旋桿菌的感染會影響逆流性食道炎病人的胃酸分泌,但是對食道蠕動功能失能程度並無顯著影嚮。綜合上述之實驗結果顯示,對於逆流性食道炎的病人而言,蠕動功能失能比感染幽門螺旋桿菌還要重要。
In the past decade, the relationship between Helicobacter pylori infection and gastroesophageal reflux disease (GERD) has became a topic of major interest in the gastroenterology literature. A single eradication study suggests that H. pylori infection may be protective with respect to reflux esophagitis. However, epidemiologic trends suggest that an inverse relationship may prevail, and some prevalence studies support that hypothesis. GERD is an acidpeptic disorder characterized by an increased exposure of the esophagus to acid, transient lower esophageal sphincter relaxation, impaired clearance of acid in the esophagus and weakened, esophageal mucosal defense are considered to be the main contributing factors in the development of GERD. Peristalsis of the esophageal body is a major component of the antireflux mechanism responsible for clearance of 90% of the refluxate. Ineffective esophageal peristalsis leads to prolonged acid exposure and induce damage to the esophageal mucosa. Reflux esophagitis has been reported to be common in the highly developed countries, such as Switzerland (11.7%), the USA (15.7%) and UK (22.8%). GERD has been considered rare in Taiwan. However, according to the recent domestic reports, the incidence of reflux esophagitis has been increased in the recent decade.
In the present study, we have evaluated that the effect of H. pylori infection in patients with reflux esophagitis. Subjects were sampled from Division of Gastroenterology Taichung Veterans General Hospital. Esophageal motility and 24-hour intragastic acidity were assessed in endoscopy proven reflux esophagitis patients with (n=50) and without (n=50) H. pylori infection. The results showed that there were no differences in the age, sex, or body mass index (BMI) between patients with and without H. pylori infection. Most of the patients had a mild degreed of esophagitis. However the 24-hour intragastic pH monitoring showed lower acidity in patients with H. pylori infection than those without H. pylori infection. The basal LES pressure was similar in both groups of patients. No difference in the patterns of esophageal motility dysfunction was noted between the two groups of patients. Based on the findings of this study, H. pylori infection affects intragastric acidity in patients with reflux esophagitis. However, the degree of esophageal motility dysfunction is similar in both groups. Therefore, motility dysfunction is more important than H. pylori infection in the pathogenesis of reflux esophagitis.
中文摘要﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍ 1
英文摘要﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍ 2
壹、 緒論﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍5
貳、 研究動機與目的﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍30
參、 研究方法﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍32
一、 材料﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍32
二、 方法﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍33
三、 統計﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍41
肆、 結果﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍42
伍、 討論﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍55
陸、 參考文獻﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍﹍58
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