兰索拉唑用药前后幽门螺杆菌在胃内分布的变化  

Distribution of Helicobacter pylori in stomach before and after the administration of Lansoprazole

作　　者：金珠[1] 董秀云[1] 林三仁[1] 叶嗣懋[1] 周丽雅[1] 成红艳 

机构地区：[1]北京大学第三医院消化科,北京100083 [2]徐州市第四医院消化科

出　　处：《北京大学学报（医学版）》2005年第2期183-186,共4页Journal of Peking University:Health Sciences

摘　　要：目的: 探讨抑酸药兰索拉唑对幽门螺杆菌Helicobacterpylori(简称H.pylori)在胃内分布的影响。方法:检查 43例有H.pylori感染的十二指肠溃疡患者在服用兰索拉唑前后的胃镜活检组织切片,活检部位分别为窦小弯及体大弯,对活检组织切片做HE及Warthin Starry嗜银染色,观察窦体两部位H.pylori检出率、密度及胃炎活动程度的变化。结果: (1)窦小弯用药前、用药后 4周及 3个月H.pylori的检出率分别为 93. 02%, 58. 14%和 86. 05%,用药后 4周H.pylori检出率及密度明显低于用药前及用药后 3个月(均P<0. 01)。(2)体大弯用药后 4周和 3个月H.pylori的密度较用药前增加。(3)窦小弯用药后 4周胃炎活动性的检出率明显低于用药前及用药后 3个月,胃炎活动程度也轻于后两者。(4)体大弯用药后 4周和 3个月胃炎活动性检出率较用药前增加,胃炎活动程度也加重。(5)窦小弯及体大弯用药前后胃炎活动性与H.pylori检出率之间变化呈正相关 (分别为r=0. 995 1,r=0. 960 8)。结论: 兰索拉唑可使幽门螺杆菌在胃内的定植部位发生改变,窦小弯H.pylori检出率下降、密度减少,而体大弯密度增加,此种影响在用药后 1个月左右最为明显,胃炎活动性与H.pylori检出率的变化关系密切。Objective: To investigate the effect of the acid inhibitor-Lansoprazole on the distribution of Helicobacter pylori (H.pylori) in stomach. Methods: Biopsy specimens were taken from the duodenal ulcer patients who underwent gastroscopy before and after the treatment of Lansoprazole. The biopsy specimens were taken from the lesser curvature of the antrum and the greater curvature of the corpus respectively. H&E and Warthin-Starry staining were used for detecting the changing of active gastritis and the positive rate of H.pylori. Results: (1)The positive rates of H.pylori before treatment, 4 weeks after treatment and 3 months after treatment, in the lesser curvature of the antrum were 93.02%, 58.14%, and 86.05%, respectively. The positive rate and density of H.pylori 4 weeks after treatment were greatly decreased compared with those before treatment (P<0.001) and also lower than those 3 months after treatment (P<0.05). (2) The positive rate of H.pylori before treatment, 4 weeks after treatment and 3 months after treatment in greater curvature had differences without statistical significance. However, the density of H.pylori 4 weeks after treatment was increased compared with that before treatment. Conclusion: Lansoprazole can change the colonization site of H.pylori in the stomach, decrease the positive rate and the density of H.pylori in lesser curvature of the antrum, but increase the density of H.pylori in the greater curvature of the corpus. This effect is most obvious in one month after treatment. Active gastritis is related to H.pylori.

关 键 词：幽门螺杆菌 兰索拉唑 胃内分布 用药前 WARTHIN-STARRY Helicobacter H.pylori感染 胃炎活动性 活检组织切片 十二指肠溃疡 检出率 用药后 活检部位 嗜银染色 密度减少 变化关系 大弯 抑酸药 正相关 

分 类 号：R573.1[医药卫生—消化系统] R573.105[医药卫生—内科学]