Endoscopic gastric mucosal atrophy changes after Helicobacter pylori eradication and their predictive factors
10.3760/cma.j.cn321463-20240408-00116
- VernacularTitle:幽门螺杆菌根除后内镜下胃黏膜萎缩的变化及其预测因素研究
- Author:
Chengyao WANG
1
;
Linlin SHAO
1
;
Wenkun LI
1
;
Rui CHENG
1
;
Xi ZHANG
1
;
Zheng ZHANG
1
;
Peng LI
1
;
Shutian ZHANG
1
;
Jing WU
1
Author Information
1. 首都医科大学附属北京友谊医院消化内科，北京 100050
- Publication Type:Journal Article
- Keywords:
Helicobacter pylori;
Eradication;
Chronic gastritis;
Gastric mucosal atrophy
- From:
Chinese Journal of Digestive Endoscopy
2025;42(6):462-468
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify risk factors associated with endoscopic atrophic progression of gastric mucosa after Helicobacter pylori ( HP) eradication and to develop a risk scoring system for establishing an individualized endoscopic follow-up strategy for patients with chronic gastritis. Methods:This retrospective cohort study included chronic gastritis patients with successful HP eradication at the Department of Gastroenterology, Beijing Friendship Hospital between January 2018 and October 2021. Demographic characteristics, endoscopic findings, and other clinical data were analyzed. Endoscopic outcomes of gastric mucosal atrophy before and after follow-up were compared to classify patients into progression and non-progression groups. Univariate and multivariate analyses were performed to identify independent risk factors for endoscopic atrophic progression. A risk scoring system was then constructed based on these factors. Results:A total of 218 patients with chronic gastritis were included, including 153 in the non-progression group and 65 in the progression group. Multivariate logistic regression analysis showed that gastric ulcer ( P=0.008, OR=4.24, 95% CI: 1.46-12.25), history of proton pump inhibitor use ( P=0.007, OR=4.06, 95% CI: 1.46-11.27), alcohol consumption ( P=0.002, OR=3.77, 95% CI: 1.64-8.67), high-salt diet ( P=0.008, OR=2.90, 95% CI: 1.32-6.41), and high red meat intake ( P=0.025, OR=2.33, 95% CI: 1.11-6.31) were independent risk factors for endoscopic atrophic progression after HP eradication. The predictive model based on these 5 factors demonstrated strong discriminative capacity, with an area under the receiver operating characteristic curve of 0.813 (95% CI: 0.755-0.876, P<0.001). The optimal cut-off value was 1.5 points, stratifying patients into low-risk (0-2 points) and high-risk (3-5 points) groups. Conclusion:Patients with chronic gastritis remain susceptible to progression even after successful HP eradication. Individualized endoscopic follow-up strategies should be considered based on patients' medical history, medication use, lifestyle, and dietary habits.
