幽门螺杆菌长期感染对胃粘膜的影响  

Effects of Helicobacter pylori infection on gatric mucosa

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

机构地区：[1]江西医学院第一附属医院消化研究所,南昌330006

出　　处：《中华消化内镜杂志》2001年第4期204-206,共3页Chinese Journal of Digestive Endoscopy

基　　金：江西省自然科学基金 (NO: 974056);国家自然科学基金 (NO:39660078)资助项目

摘　　要：目的为了研究 Hp长期感染对胃粘膜病变转归的影响。方法随防了 63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① 63例患者中 16例（ 25.4％） Hp转阴， 47例 (74.6％ )Hp持续阳性。② Hp持续阳性者 10年前后消化性溃疡（ PU）的发生率分别为 14例（ 29.78％）和 25例（ 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 11例（ 68.8％）和 2例 (12.5％ ) (P < 0.05)。③ Hp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（ IM）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 8例 (17.02％ )和 18例 (38.29％ ) (P < 0.05)， IM的发生分别为 8例 (17.02％ )和 21例 (44.68％ )（ P < 0.01）； Hp转阴者 10年前后 IM的发生均为 5例（ 31.25％） ,胃粘膜糜烂 10年后完全消失。结论 Hp持续感染可增加消化性溃疡的发生机率，加剧胃粘膜的炎症程度，并促进肠化?Object To study the effects of Helicobacter pylori(H.pylori) infection on gastric mucosa.Methods The 63 patients who was H.pylori positive for 10 years were examined by endoscopy and pathology.Results① Ten years later 16/63(25.4％ ) patients were H.pylori negative and 47/63(74.6％ ) patients persistent H.pylori positive.② At 10－ year follow up the H.pylori persistent positive and negative patients have the incidence of peptic ulcer naising from 29.78％ to 53.19％ (P< 0.05) and decreasing from 68.18％ to 12.5％ (P< 0.05)respectively.③ The initial and 10－ year follow－ up data were that the gastritis scores were 1.77± 0.43 and 2.13± 0.34(P< 0.01)and the intestinal metaplasia scores 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) and the intestinal metaplasia scores 1.6± 0.55 and 1.4± 0.59(P >0.05)respectively.④ The initial and 10－ year follow－ up data were that the incidences of erosion of gastric mucosa were 17.02％ and 38.29％ (P< 0.05) and those of intestinal metaplasia were 17.02％ and 44.68％ (P< 0.01)respectively in H.pylori persistent positive patients,but in H.pylori negative patients the incidences of erosion of gastric mucosa were 18.75％ and 0％ (P< 0.01)and these of intestinal metaplasia were all 31.25％ repectively.Conclusion The persistent H.pylori infection can increase the incidence of peptic ulcer,aggravate the 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：胃炎 消化性溃疡 螺杆菌 幽门 肠上皮化生 胃粘膜 长期感染 

分 类 号：R573[医药卫生—消化系统]