Research objective. То study the genotypes of Helicobacter pylori and their antibiotic sensitivity in patients with stable angina in combination with chronic gastritis. Material and methods. 46 patients with stable angina with a combination of chronic H. pylori-associated gastritis were included in the open prospective clinical study. To diagnose H. pylori, serological method of detection of antibodies in blood serum was used, PCR - diagnosis of H. pylori genes. Antibiotic sensitivity of H. pylori strains was studied by serial dilution method. Results. In the patients (n = 46) stable angina in combination with chronic gastritis in the endoscopic study by the EGDS method, gastrobioptates were obtained and further investigated. Chronic neatrophic gastritis was diagnosed in 54.3% of patients, atrophic gastritis - in 45.7%. It was found that the genotypes of H. pylori VacA had 8.7% of patients, CagA - 34.7%, HopQ - 13.1%, Oip - 30.4% of patients. Only 13.1% of patients had non-toxic genotypes. The absence of antibiotic resistance of the first line of erication therapy - clarithromycin and amoxicillin - was revealed. 45.7% of patients showed resistance, 39.1% showed weak sensitivity of H. pylori isolates to metronidazole. Conclusions. In patients with stable angina with a combination of chronic gastritis, H. pylori strains with toxigenic genotypes: CagA, Oip, Vac A, HopQ predominate. Resistance of H. pylori isolates to metronidazole was determined in 45.7% of patients.

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. 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.

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