幽门螺杆菌长期感染对胃粘膜的远期影响——10年随防研究  

Long-Term Effects of Helicobacter Pylori Infection on Gastric Mucosa:A 10-Year Follow-Up Study

作　　者：谢勇[1] 吕农华[1] 陈江[1] 徐萍[1] 王崇文[2] 黄德强[1] 周小江[1] 祝金泉 张昆和[1] 

机构地区：[1]南昌 江西医学院一附院消化研究所,330006 [2]南昌 江西医学院一附院消化研究,所330006

出　　处：《现代消化及介入诊疗》2001年第1期17-20,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的研究Hp长期感染对胃粘膜病变的转归的影响。方法随防了62例10年前Hp感染患者。并分析对比10年前后Hp感染情况、胃镜和病理组织学变化。结果①363例患者16例(25.4％)Hp转阴,47例(74.6％)Hp持续阳性。②Hp持续阴性者10年前后消化性溃疡(PU)的发生率分别为29.78％和53.19％(P<0.05),Hp转阴者10年前后消化性溃疡(PU)的发生率分别为68.8％和12.5％(P<0.05)③Hp持续阳性者10年前后慢性炎症严重程度积分分别为1.77±0.43和2.13±0.34(P<0.01),肠上皮化生(IM)严重程度积分分别为1.13±0.35和1.63±0.52(P<0.05);Hp转阴者10年前后慢性炎症严重程度积分分别为1.81±0.40和1.31±0.48(P<0.01),肠上皮化生(1M)严重程度积分分别为1.6±0.55和1.4±0.59(P<0.05);Hp持续阳性者10年前后胃粘膜糜烂的发生分别为17.02％和38.29％(P<0.05),IM的发生分别为17.02％和44.68％(P<0.01);Hp转阴者lO年前后IM的发生均为31.25％,胃粘膜糜烂10年后完全消失。结论根除Hp不仅能减轻胃粘膜的炎症程度,而且能阻止肠化的发生和发展。Objective To study long-term effects of Helicobacter pylori (H.pylori) infection on gastric mucosa. Methods The 63 patients who were H.pylori positive before decade were examined by endoscopy and pathology. Results ① 16/63(25.4%)patients were H.pylori negative and 47/63(74.6%)Patients persistent H.pylori positive. ②Before and after decade the incidence of peptic ulcer was 29.78% and 53.19% (P<0.02) respectively in H.pylori persistent positive patients, but in H. Pylori negative patients those were 68.8% and 12.5% (P<0.05) respectively. ③Before and after decade the gastritis scores were 1.77 ±0.43 and 2.13± 0.34(P<0.01)respectively and the intestinal metaplasia scores were 1.13±0.35 and 1.63±0.52(P<0.05) respectively in H.pylori persistent positive patients, but in H.pylori negative patients the gastritis scores were 1.81±0.40 and 1.31 ±0.48(P<0.01) respectively and the intestinal metaplasia scores were 1.6 ±0.55 and 1.4 ± 0.59(P<0.05) respectively. ④Before and after decade the incidence of erosion of gastric mucosa was 17.02% and 38.29%(P<0.05)respectively and the incidence of intestinal metaplasia was 17.02% and 44.68%(P<0.01)respectively in H.pylori persistent positive patients, but in H.pylori negative patients the incidence of erosion of gastric mucosa was 18.75% and 0%(P<0.01) respectively and the incidence intestinal metaplasia was all 31.25%. Conclusion The H.pylori persistent infection can increase the incidence of peptic ulcer, aggravate inflammation of gastric mucosa, and accelerate the generation and progress of intestinal metaplasia. Eradication of H.pylori not only can reduce inflammation of gastric mucosa, but also prevent the generation and progress of intestinal metaplasia.

关 键 词：胃粘膜 转阴 严重程度 阳性 Hp感染 肠上皮化生 远期影响 糜烂 慢性炎症 幽门螺杆菌 

分 类 号：R573[医药卫生—消化系统] R735.2[医药卫生—内科学]