The Study On Helicobacter Pylori Infection And Anxiety-depression In Chronic Gastritis

Objective:To understand the prevalence of anxiety-depression in chronic gastritis and investigate the relationship between anxiety-depression and H.pylori infection,and their relationship with upper gastrointestinal symptoms,the degree of inflammation,activity,atrophy,intestinal metaplasia in chronic gastritis,To provide scientific basis for effective prevention and treatment of chronic gastritis.Methods:Total of 365 patients with chronic gastritis were enrolled.The questionnaire,SAS,SDS and 13 C urea breath test were used in chronic gastritis patients who had upper gastrointestinal(GI)symptoms and gastroscopy and pathological examination to collect general information,the indices such as poor diet habits,smoking,drinking and H.pylori infection,investigating the scores in digestive symptoms and anxiety and depression.The incidence of anxiety-depression and its correlation with H.pylori infection,and their relationship with upper gastrointestinal(GI)symptoms,the degree of inflammation,activity,atrophy,intestinal metaplasia in chronic gastritis were analyzed using applying statistical analysis software.Results:1.In the 365 cases,165(45.2%)of them were accompanied by anxiety,212 patients(58.1%)were accompanied by depression,146 patients(40.0%)were accompanied by anxiety and depression.A total of 231 patients(63.3%)were accompanied by anxiety and/or depression.There are higher incidence of anxiety in middle-aged and female patients.2.The positive rate of H.pylori infection in patients accompanied by anxiety and /or depression is 68.8%,which was significantly higher than those patients without anxiety and depression.3.The clinical manifestations of patients were abdominal pain(50.4%),abdominal distension(40.8%),nausea(22.1%),belching(38.6%),early satiety(38.1%)acid reflux and/or heartburn(43.0%).Incidence of abdominal pain,abdominal distention and early satiety,scores of digestive symptoms in patients accompanied by anxiety and/ordepression were significantly higher than those patients without anxiety and depression.Compared with H.pylori negative patients and H.pylori positive patients,there had no significant difference in scores of digestive symptoms and the incidence of gastrointestinal symptoms.4.The pathological features of patients: Mild inflammation(14.2%),moderate inflammation(38.7%),severe inflammation(47.1%);active inflammation accounted for86.0%,of which mild(38.6%),moderate(42.5%),severe(4.9%),atrophy accounted for26.6%,intestinal metaplasia accounted for 31.8%.Regression analysis showed: the factors that affect the degree of inflammation in chronic gastritis are poor diet preferences,smoking,drinking,H.pylori infection and anxiety-depression.the factors that affect atrophy are age more than 60 years old,smoking and H.pylori infection.H.pylori infection is also a risk factor for activity of inflammatory and intestinal metaplasia.but there was no significant correlation between anxiety-depression and atrophy,intestinal metaplasia and activity of inflammation in chronic gastritis.Conclusion:1.The incidence rate of anxiety and depression in patients with chronic gastritis is high,the incidence of anxiety was higher in women and middle-aged patients.2.The patients with depression and/or anxiety are prone to H.pylori infection.3.Anxiety-depression can aggravate the upper GI symptoms in patients,which are associated with abdominal pain,abdominal distention and early satiety.H.pylori infection is not correlated with incidence and severity of upper GI symptoms.4.H.pylori infection can affect the degree of inflammation,activity,atrophy and intestinal metaplasia of gastric mucosa,while anxiety and/or depression only have an effect on degree of inflammation.