目的　探讨幽门螺杆菌 (Hp)清除与否与胃黏膜病理转归的关系。 方法　 191例Hp感染的胃炎或溃疡病患者分别随机给予抗Hp或非抗Hp治疗 ,1年后复查胃镜 ,病理分型根据悉尼系统。 结果　 191例患者中 ,慢性炎症 1年后的炎症程度较 1年前减轻 (P <0 .0 5 ) ,其中萎缩和肠化生的程度也较前减轻 (P <0 .0 5 ) ,但活动性炎症程度前后比较差异无显著性 (P <0 .0 5 )。根据 1年后胃镜复查有无Hp清除分为两个队列 ,Hp清除列有 10 7例 ,Hp未清除列有 84例。Hp清除列较未清除列 1年后慢性炎症程度轻 (P <0 .0 5 ) ,活动性炎症者少 (P <0 .0 5 )。对不同的疾病和不同的治疗分层后发现 ,Hp清除者的胃黏膜炎症程度总是较Hp未清除者轻 (P <0 .0 5 )。 结论　本研究提示 ,Hp感染与胃黏膜活动性炎症关系较为密切。Hp清除有利于胃黏膜炎症程度的减轻 Objective To investigate the relationship between Helicobacter pylori (Hp) clearance and gastric mucosal pathological changes. Methods A total of 191 Hp-infected patients with gastritis or ulcer were randomized to anti-Hp or non-anti-Hp treatment. Gastroscopy was performed one year later. The pathological classification was based on the Sydney system. Results Among the 191 patients, the degree of inflammation after 1 year of chronic inflammation was relieved (P <0. 05), and the degree of atrophy and intestinal metaplasia was also reduced (P <0. 05) The level of active inflammation before and after the difference was not significant (P <0.05). According to 1 year after the endoscopy whether Hp clearance was divided into two cohorts, Hp clearance 107 cases, Hp not clear 84 cases. Chronic inflammation was less (P <0.05) in Hp-cleared patients than in un-cleared patients, and less in active inflammatory patients (P <0.05). Stratification of different diseases and different treatments found that gastric mucosal inflammation in Hp-eradicated patients was always less severe than those with no Hp (P <0.05). Conclusion This study suggests that Hp infection is closely related to active inflammation of gastric mucosa. Hp clearance is conducive to reduce the degree of gastric mucosal inflammation