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DOI 10.34014/2227-1848-2020-4-30-39
CHRONIC GASTRITIS AND OLD AGE: A PROBLEM OR NOT?
Zh.G. Simonova, M.N. Prikhod'ko, E.M. Shul'gina
Kirov State Medical University, Ministry of Health of the Russian Federation, Kirov, Russia
The objective of the paper is to study the clinical and functional characteristics of chronic H. pylori-associated gastritis in the elderly patients.
Materials and Methods. A group of elderly patients (n=116) (aged 69.5±3.2) with chronic H. pylori-associated gastritis was formed during a prospective clinical study. All patients underwent esophagogastroduodenoscopy with biopsy. OLGA staging system was used for histological assessment. The dyspeptic index (DI) was used to measure dyspepsia. The patients were followed up for 48 weeks.
Results. Dyspepsia was found only in 41.3 % of patients, while 58.7 % of patients had asymptomatic disease progression. Atrophic changes in the gastric mucosa were found in 30.1 % of the trial subjects. The efficacy of the eradication therapy was 88.7 %. During the study, the endoscopic picture of the gastroduodenal zone improved. There was no progression of atrophic and metaplastic changes in the gastric mucosa.
Conclusion. Thus, in elderly patients, chronic H. pylori-associated gastritis is often asymptomatic. Eradication of H. pylori infection promotes disease remission and prevents morphological changes in the gastric mucosa.
Keywords: chronic gastritis, Helicobacter pylori, atrophic gastritis, dyspepsia, old age, eradication therapy.
Conflict of interest. The authors declare no conflict of interest.
References
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Received 15 September 2020; accepted 04 November 2020.
Information about the authors
Simonova Zhanna Georgievna, Doctor of Medical Sciences, Professor, Chair of Hospital Therapy, Kirov State Medical University, Ministry of Health of the Russian Federation. 610998, Russia, Kirov, K. Marks St., 112; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-9772-3867.
Prikhod'ko Maksim Nikolaevich, Teaching Assistant, Chair of Hospital Therapy, Kirov State Medical University, Ministry of Health of the Russian Federation. 610998, Russia, Kirov, K. Marks St, 112; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-4932-2054.
Shul'gina Ekaterina Mikhaylovna, Post-Graduate Student, Chair of Hospital Therapy, Kirov State Medical University, Ministry of Health of the Russian Federation. 610998, Russia, Kirov, K. Marks St, 112; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-2059-390X.
For citation
Simonova Zh.G., Prikhod'ko M.N., Shul'gina E.M. Khronicheskiy gastrit i pozhiloy vozrast: est' li problema? [Chronic gastritis and old age: a problem or not?]. Ul'yanovskiy mediko-biologicheskiy zhurnal. 2020; 4: 30–39. DOI: 10.34014/2227-1848-2020-4-30-39 (in Russian).
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УДК 616.33-002.2-053.9
DOI 10.34014/2227-1848-2020-4-30-39
ХРОНИЧЕСКИЙ ГАСТРИТ И ПОЖИЛОЙ ВОЗРАСТ: ЕСТЬ ЛИ ПРОБЛЕМА?
Ж.Г. Симонова, М.Н. Приходько, Е.М. Шульгина
ФГБОУ ВО «Кировский государственный медицинский университет» Минздрава России, г. Киров, Россия
Цель – изучить клинико-функциональные особенности течения хронического H. pylori-ассоциированного гастрита у лиц пожилого возраста.
Материалы и методы. В процессе проспективного клинического исследования была сформирована группа больных (n=116) пожилого возраста (69,5±3,2 года) с хроническим H. pylori-ассоциированным гастритом. Всем больным была выполнена эзофагогастродуоденоскопия с биопсией. Для гистологической оценки применяли классификацию OLGA. Для оценки диспепсического синдрома использовали диспепсический индекс (ДИ). Длительность наблюдения больных составила 48 нед.
Результаты. Наличие диспепсического синдрома было установлено у 41,3 % больных, 58,7 % пациентов имели бессимптомное течение заболевания. У 30,1 % обследуемых выявлены атрофические изменения слизистой оболочки желудка. Эффективность проведенной эрадикационной терапии составила 88,7 %. В процессе исследования установлено улучшение эндоскопической картины гастродуоденальной зоны. Отмечено отсутствие прогрессирования атрофических и метапластических изменений слизистой оболочки желудка.
Выводы. У больных пожилого возраста течение хронического H. pylori-ассоциированного гастрита чаще имеет бессимптомный характер. Эрадикация инфекции H. pylori способствует ремиссии заболевания и предотвращает морфологические преобразования слизистой оболочки желудка.
Ключевые слова: хронический гастрит, Helicobacter pylori, атрофический гастрит, синдром диспепсии, пожилой возраст, эрадикационная терапия.
Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.
Литература
1. Dursun M., Yilmaz S., Yukselen V., Kilinc N., Canoruc F., Tuzcu A. Evaluation of optimal gastric mucosal biopsy site and number for identification of Helicobacter pylori, gastric atrophy and intestinal metaplasia. Hepatogastroenterology. 2004; 51 (60): 1732–1735.
2. Correa P. Helicobacter pylori and gastric carcinogenesis. Am. J. Surg. Pathol. 1995; 19: 37–43.
3. Xia H.H., Talley N.J. Apoptosis in gastric epithelium induced by Helicobacter pylori infection: Implications in gastric carcinogenesis. Am. J. Gastroenterol. 2001; 96: 16–26.
4. Morgan D.R., Crowe S.E. Helicobacter pylori infection. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. Philadelphia; 2015: 856–884.
5. Сhen H.N., Wang Z., Li X., Zhou Z.G. Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis. Gastric. Cancer. 2016; 19 (1): 166–175.
6. Graham D.Y., Lee Y.C., Wu M.S. Rational Helicobacter pylori therapy: evidence-based medicine rather than medicine-based evidence. Clinical Gastroenterology and Hepatology. 2014; 12: 177–186.
7. Wu J.Y., Liou J.M., Graham D.Y. Evidence-based recommendations for successful Helicobacter pylori treatment. Expert Rev. Gastroenterol. Hepatol. 2014; 8 (1): 21–28.
8. Rugge M., Fassan M., Pizzi M., Farinati F., Stumiolo G.C., Plebani M., Gracham D.Y. Operative link for gastritis assessment vs operative link on intestinal metaplasia assessment. World J. Gastroenterol. 2011; 17 (41): 4596–4601.
9. Шульгина Е.М., Караулова Л.В., Симонова Ж.Г. Оценка вероятности инфицированности Helicobacter pylori у больных с гастродуоденальной патологией в зависимости от факторов риска с использованием модели логит-регрессии. Вятский медицинский вестник. 2019; 3 (63): 50–57. DOI: 10.24411/2220-7880-2019-10012.
10. Takahashi S., Igarashi H., Masubuchi N., Ishiyama N., Saito S., Aoyagi T., Itoh T., Hirata I. Helicobacter pylori and the development of atrophic gastritis. Nippon Rinsho. 1993; 51 (12): 3231–3235.
11. Шиманская А.Г., Мозговой С.И., Назаров А.Н., Владимирова О.В., Кононов А.В. Атрофический гастрит как предрак: молекулярная биология и проблемы диагноза. Перспективы развития современной медицины. Вып. II. Воронеж; 2015: 139–141.
12. Yoshida T. Cancer development based on chronic active gastritis and resulting gastric atrophy as assessed by serum levels of pepsinogen and Helicobacter pylori antibody titer. Int. J. Cancer. 2014; 134 (6): 1445–1457.
13. Sipponen P., Kekki M., Haapakoski J. Gastric cancer risk in chronic atrophic gastritis: statistical calculations of cross-sectional date. Int. J. Cancer. 1985; 35: 173–177.
14. Маев И.В., Самсонов А.А., Андреев Д.Н. Инфекция Helicobacter pylori. Москва: ГЭОТАР-Медиа; 2016.
15. Correa P. Gastric cancer: overview. Gastroenterol. Clin. North. Am. 2013; 42 (2): 211–217.
16. Dinis-Ribeiro M., Areia М., Vries А.С., Marcos-Pinto R., Monteiro-Soares M., O’Connor A., Pereira C., Pimentel-Nunes P., Correia R., Ensari A., Dumonceau J.M., Machado J.C., Macedo G., Malfertheiner P., Matysiak-Budnik T., Megraud F., Miki K., O’Morain C., Peek R.M., Ponchon T., Ristimaki A., Rembacken B., Carneiro F., Kuipers E.J. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED). Endoscopy. 2012; 44: 74–94.
17. Fukase K., Kato М., Kikuchi S., Inoue R., Uemura N., Okamoto S.H. Japan Gast Study Group Effect of eradication of Helicobacter pylori on incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer: an open-label, randomized controlled trial. Lancet. 2008; 372: 392–397.
18. Lee Y.C., Chen T.H., Chiu H.M., Shun C.T., Chiang H., Liu T.Y., Wu M.S., Lin J.T. The benefit of mass eradication of Helicobacter pylori infection: a community-based study of gastric cancer prevention. Gut. 2013; 62 (5): 676–682.
Поступила в редакцию 15.09.2020; принята 04.11.2020.
Авторский коллектив
Симонова Жанна Георгиевна – доктор медицинских наук, профессор кафедры госпитальной терапии, ФГБОУ ВО «Кировский государственный медицинский университет» Минздрава России. 610998, Россия, г. Киров, ул. К. Маркса, 112; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-9772-3867.
Приходько Максим Николаевич – ассистент кафедры госпитальной терапии, ФГБОУ ВО «Кировский государственный медицинский университет» Минздрава России. 610998, Россия, г. Киров, ул. К. Маркса, 112; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-4932-2054
Шульгина Екатерина Михайловна – аспирант кафедры госпитальной терапии, ФГБОУ ВО «Кировский государственный медицинский университет» Минздрава России. 610998, Россия, г. Киров, ул. К. Маркса, 112; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0003-2059-390Х.
Образец цитирования
Симонова Ж.Г., Приходько М.Н., Шульгина Е.М. Хронический гастрит и пожилой возраст: есть ли проблема? Ульяновский медико-биологический журнал. 2020; 4: 30–39. DOI: 10.34014/2227-1848-2020-4-30-39.