目的 探讨肠道菌群失调与大肠息肉、幽门螺杆菌（Hp）感染肠化生的相关性。 方法 选取2024年5月至2025年4月收治的大肠息肉、Hp感染肠化生、大肠息肉伴Hp感染肠化生患者共计200例，其中大肠息肉组（n = 90）、Hp感染肠化生组（n = 49）、大肠息肉伴Hp感染肠化生组（n = 61）；纳入同期我院行健康体检人群62例，设为对照组；对比不同组别患者肠道菌群失调情况，分析肠道菌群失调与大肠息肉、Hp感染肠化生、大肠息肉伴Hp感染肠化生的相关性；logistic回归分析大肠息肉发生Hp感染肠化生的危险因素。 结果 与对照组相比，大肠息肉组、Hp感染肠化生组、大肠息肉伴Hp感染肠化生组菌群失调发生率均较高（P < 0.05），大肠息肉伴Hp感染肠化生组菌群失调发生率高于大肠息肉组、Hp感染肠化生组（P < 0.05）；呼气H₂、呼气CH₄对比，大肠息肉伴Hp感染肠化生组、大肠息肉组、Hp感染肠化生组严重程度高于对照组（P < 0.05）；呼气H₂S对比，大肠息肉伴Hp感染肠化生组高于对照组（P < 0.05）。呼气H₂、呼气CH₄指标与大肠息肉、Hp感染肠化生、大肠息肉伴Hp感染肠化生呈正相关（P < 0.05），呼气H₂S指标与大肠息肉伴Hp感染肠化生呈正相关（P < 0.05）；logistic回归分析结果显示，存在吸烟史、萎缩性胃炎、消化性溃疡、肠道菌群失调为大肠息肉患者发生Hp感染肠化生的危险因素（P < 0.05）。 结论 肠道菌群失调与大肠息肉、Hp感染肠化生存在相关性，肠道菌群失衡可能是导致大肠息肉和Hp感染肠化生发生的危险因素之一。

Objective To investigate the association between intestinal microbiota dysbiosis and colonic polyps， Helicobacter pylori （Hp） infection， and intestinal metaplasia. Methods A total of 200 patients diagnosed with colonic polyps， Hp infection， or both conditions. These patients were classified into three groups： the colonic polyp group （n = 90）， the Hp infection with intestinal metaplasia group （n = 49）， and the colonic polyp combined with Hp infection and intestinal metaplasia group （n = 61）. Additionally， 62 individuals who underwent routine health examinations at our hospital during the same period were enrolled as a control group. The study compared gut microbiota imbalances across these groups to investigate the association between intestinal dysbiosis and colonic polyps， Hp infection， and the co?occurrence of colonic polyps with Hp?related intestinal metaplasia. Logistic regression analysis was performed to identify risk factors associated with the development of intestinal metaplasia due to Hp infection in patients with colonic polyps. Results Compared to the control group， intestinal flora imbalance was significantly more prevalent in the colorectal polyp group， the Hp infection with intestinal metaplasia group， and the colorectal polyp combined with Hp infection and intestinal metaplasia group （P < 0.05）. Moreover， intestinal flora imbalance in the colorectal polyp with Hp infection and intestinal metaplasia group was significantly higher than that in both the colorectal polyp group and the Hp infection with intestinal metaplasia group （P < 0.05）. Regarding exhaled gas levels， H₂ and CH₄ concentrations were significantly elevated in the groups with colorectal polyps accompanied by Hp infection and intestinal metaplasia， those with colorectal polyps alone， and those with Hp infection and intestinal metaplasia， compared to the control group （P < 0.05）. Similarly， exhaled H₂S levels were significantly higher in the group with colorectal polyps complicated by Hp infection and intestinal metaplasia than in the control group （P < 0.05）. Furthermore， exhaled H₂ and CH₄ levels showed positive correlations with the presence of colorectal polyps， Hp infection with intestinal metaplasia， and colorectal polyps combined with Hp infection and intestinal metaplasia （P < 0.05）. Exhaled H₂S levels were positively correlated with colorectal polyps complicated by Hp infection and intestinal metaplasia （P < 0.05）. Logistic regression analysis indicated that a history of smoking， atrophic gastritis， peptic ulcer， and intestinal flora imbalance are independent risk factors for Hp infection-associated intestinal metaplasia in patients with colorectal polyps （P < 0.05）. Conclusion Intestinal flora imbalance is associated with colorectal polyps and Hp?induced intestinal metaplasia， suggesting that microbial dysbiosis may represent a potential risk factor for the development of these conditions.