Study On The Relevance Between Inflammatory Bowel Disease And Helicobacter Pylori

Objective:To explore the relationship between inflammatory bowel disease(IBD)and Helicobacter pylori(Hp)infection.To provide new ideas for the prevention and treatment of IBD.Methods:In this study,577 patients with IBD who were treated in the First Affiliated Hospital of Kunming Medical University from January 2012 to December 2017 were selected as the experimental group,including 454 UC patients and 123 CD patients.130 patients without obvious intestinal lesions examined by colonoscopy at the same period were chosen as control group.C13 breath test was used as the diagnostic criterion for Hp infection.The infection of Hp type I and Hp type II was diagnosed by immunoblotting.The detection items were C13 breath test and immunoblotting for serum CagA antibody,Vac A antibody,UreB antibody,UreA antibody.The infection of Hp was compared between the experimental group and the control group.IBD patients were grouped according to the degree of disease activity,location and phenotype of inflammatory bowel disease,the infection rate of Hp among the groups was compared.The influencing factors of Hp infection were analyzed by logistic regression.Results:There was no statistical difference between IBD group and control group in general situation.The infection rate of Hp in IBD group(31.37%)was lower than that in control group(52.31%).The difference was statistically significant(P<0.05);2.The infection rate of Hp in UC group(32.81%)was lower than that in control group(52.31%)with statistical significance(P<0.017);the infection rate of Hp in CD group(26.02%)was lower than that in control group(52.31%)with statistical significance(P<0.017);the positive rate of type I in UC group(18.94%)was lower than that in control group(32.31%)with statistical significance(P<0.017).The positive rate of type ? in group ?(18.70%)was lower than that in group ?(32.31%)in control group(P<0.017).There was no significant difference in the positive rate of type ? between UC group,CD group and control group(P>0.017);3.UC group was divided into El group,E2 group and E3 group according to the location of the lesion.The infection rate of Hp was 45.52%,31.97%and 23.53%respectively.It showed that the infection rate of Hp decreased with the increase of the lesion scope.The infection rate of Hp in E1 group and E2 group had statistical significance(P<0.017);the infection rate of Hp in E1 group and E3 group had statistical significance(P<0.017);the infection rate of Hp in E2 group and E3 group had no statistical significance.The positive rates of type ? in group E1,E2 and E3 were 27.58%,9.84%and 18.18%,respectively.The positive rates of type ? in group E1 were different from those in group E2,and the difference was statistically significant(P<0.017);there was no significant difference between group E1 and E3,E2 and E3.There were 11.03%,10.66%and 4.81%in group E1,E2 and E3,respectively.There was no significant difference among the three groups(X2=5.187,P=0.075);4.The UC group was divided into mild activity group,moderate activity group and severe activity group according to the degree of disease activity.The infection rate of Hp was 44.14%,29.34%and 18.00%respectively,which indicated that the infection rate of Hp decreased with the increase of the extent of disease.The infection rate of Hp in E1 group was different from that in E2 group,and the difference was statistically significant(P<0.017);the infection rate of Hp in E1 group was different from that in E3 group,and the difference was statistically significant(P<0.017);there was no significant difference in the infection rate of Hp between E2 group and E3 group.The positive rates of mild activity group,moderate activity group and severe activity group were 19.31%,20.85%and 8.00%respectively.There was no significant difference among the three groups.The positive rates of mild activity group,moderate activity group and severe activity group were 11.03%,6.95%and 8.00%respectively.There was no significant difference among the three groups;5.There was no significant difference between the age of diagnosis,lesion location,disease behavior,level of disease activity and Hp infection in CD group;6.The infection rate of Hp in newly diagnosed UC group(32.99%)was lower than that of control group(52.31%).The difference was statistically significant(X2/t=8.411,P<0.05).There was no significant difference between the experimental group and the control group in terms of lesion location and level of disease activity;7.Logistic regression analysis of influencing factors of Hp infection showed that use of hormones and antibiotics were protective factors of Hp infection.Conclusion:1.The infection rate of Hp in control group was higher than that in IBD group,UC group,UC group and CD group.Hp infection may be a protective factor for the pathogenesis of IBD and the type I Hp strain may plays a protective factor.2.In UC group,the infection rate of Hp decreases with the increase of lesion range,and with the increase of disease activity,the infection rate of Hp decreases.Hp infection may reduce the extent of disease of IBD and reduce the level of disease activity.3.The history of sulfadiazine and mesalazine did not affect the infection of Hp in IBD patients.Hormone and antibiotics were the protective factors of Hp infection.