慢性胃炎患者治疗前后胃内幽门螺杆菌的分布特点  

Intragastric distribution of H.pylori before and after triple therapy in patients with chronic gastritis

作　　者：王宝林[1] 郭江华[1] 李洁 董连英 李宗辉[1] 

机构地区：[1]华北石油管理局总医院消化内科

出　　处：《华人消化杂志》1998年第6期524-525,共2页

摘　　要：目的研究根除治疗前后幽门螺杆菌在胃内的分布特点．方法有消化道症状，Ｈｐ＋慢性胃炎患者９０例，其中男５２例，女３８例，年龄１９岁～７４岁，平均４４岁．采用ＣＢＳ，ＦｕＺ，Ｍｅｔ三联治疗２ｗｋ，在根除治疗前及治疗结束４ｗｋ后从胃底、胃体、角切迹、幽门前大弯侧多部位取活检，以ＷａｒｔｈｉｎＳｔａｒｙ染色检测Ｈｐ，ＨＥ染色观察局部胃炎程度．结果三联治疗前Ｈｐ呈全胃分布，各部位Ｈｐ阳性率无明显差异（Ｐ＞００５），但Ｈｐ数量和胃炎程度各部位有差异，且有明显相关性（ｒ＝０９４８），以角切迹Ｈｐ数量最多，胃炎程度最重，局灶性萎缩、活动性胃炎的发生率亦最高．２２例根除治疗后Ｈｐ仍阳性患者，以胃底检出率最高（９０９％），角切迹最低（３１８％），两部位相比有显著差异（χ２＝１４４，Ｐ＜００１）．结论角切迹是治疗前Ｈｐ的最佳检测部位，胃底是治疗后Ｈｐ的最佳检测部位．AIM To investigate the intragastric distribution of Helicobacter pylori (Hp) before and after the radical treatment for Hp. METHODS Ninety patients with symptomatic chronic gastritis were involved in the present study, 52 were males and 38 females, aged from 19 to 74 with a mean age of 44 years. All patients had positive identification of Hp. The gastroscopic biopsy was carried out before triple therapy (CBS, FuZ and Met for two weeks) and four weeks after treatment from fundus, corpus, gastric angle and pre pyloric greater curvature. Hp was identified by Warthin Starry stain and the severity of local gastritis was valued by HE stain. RESULTS Hp was distributed pan gastrically before the radical treatment proceeded, with no significant difference in detectable rate among all the positions ( P >0 05). There was significant difference in the amount of Hp bacteria and severity of gastritis from different parts, which were correlated to each other significantly (correlation coefficient=0 948). The amount of Hp and severity of gastritis were highest in gastric angle with the highest detectable rate for local atrophy and active gastritis. In 22 patients with positive Hp after the radical treatment, the detectable rate of Hp was highest in fundus (90 9%) and lowest in gastric angle (31 8%), which were significantly different from each other (χ 2=14 4, P <0 01). CONCLUSION Gastric angle and fundus were the best positions for Hp detection before and after the radical treatment.

关 键 词：螺杆菌感染 胃炎 治疗 幽门螺杆菌 

分 类 号：R573.305[医药卫生—消化系统]