摘要目的:分析合并幽门螺杆菌( HP)感染或未感染的自身免疫性胃炎(AIG)患者内镜表现和病理特征的差异，探究 HP对AIG患者临床表现和疾病发展的影响。 方法:纳入2022年1月至2024年4月在北京医院就诊并符合2022年日本消化内镜学会AIG诊断标准的174例AIG患者，分为 HP感染组(包括现症感染和既往感染，77例)和 HP未感染组(97例)。分析两组患者的一般资料、实验室检查结果、内镜表现、病理学特征。统计学方法采用独立样本 t检验和卡方检验。 结果:HP感染组的维生素B 12水平高于 HP未感染组[(573.81±460.77) ng/L比(411.86±335.00)ng/L，差异有统计学意义( t＝－2.57， P＝0.011)]，平均红细胞体积低于 HP未感染组[(87.30±8.86) fL比(98.50±49.82) fL]，差异有统计学意义( t＝2.16， P＝0.033)]，胃体肠上皮化生的患者比例低于 HP未感染组[50.6%(39/77)比73.2%(71/97)]，差异有统计学意义( χ2＝9.38， P＝0.002)]。 结论:合并 HP感染可能延缓了AIG患者维生素B 12的吸收障碍和胃底腺肠上皮化生的发生。

abstractsObjective:To analyze the differences in endoscopic and pathological features in autoimmune gastritis (AIG) patients with and without Helicobacter pylori ( HP) infection, and to explore the effects of HP on the clinical manifestations and disease development in AIG patients. Methods:From January 2022 to April 2024, 174 AIG patients who visited Beijing Hospital and met the 2022 AIG diagnostic criteria established by Japanese Gastroenterological Endoscopy Society were enrolled and divided into the HP-infected group (including current and previous infection, 77 cases) and the HP-unifected group (97 cases). The general clinical data, laboratory examinations endoscopic findings, and pathological characteristics of the two groups were analyzed. Independent sample t-test and chi-square test were used for statistical analyses. Results:The vitamin B 12 level of HP-infected group was higher than that of HP-unifected group ((573.81±460.77) ng/L vs. (411.86±335.00) ng/L), and the difference was statistically significant ( t=-2.57, P=0.011). The average red blood cell volume of HP-infected group was lower than that of HP-unifected group ((87.30±8.86) fL vs. (98.50±49.82) fL), and the difference was statistically significant ( t=2.16, P=0.033). The proportion of intestinal metaplasia in gastric fundus in HP-infected group was lower than that in HP-unifected group (50.6% (39/77) vs. 73.2% (71/97)), and the difference was statistically significant ( χ2=9.38, P=0.002). Conclusion:HP infection in AIG patients may delay the malabsorption of vitamin B 12 and the occurrence of intestinal metaplasia in gastric fundus.