Futami H, Takashima M, Furuta T, Hanai H, Kaneko E
First Department of Medicine, Hamamatsu University School of Medicine, Japan.
J Gastroenterol Hepatol. 1999 Feb;14(2):114-9. doi: 10.1046/j.1440-1746.1999.01824.x.
The aim of this study was to determine whether the amount of Helicobacter pylori and the extent of gastric metaplasia in the duodenal mucosa play critical roles in the pathogenesis of duodenal ulcer.
Duodenal and gastric biopsy specimens were obtained from H. pylori-positive patients with duodenal ulcer, gastric ulcer or chronic gastritis. The extent of gastric metaplasia was evaluated histologically and endoscopically using the methylene blue test. In this study, we performed competitive polymerase chain reaction, a highly sensitive and quantitative method for determining the amount of H. pylori gastric and duodenal mucosa. The prevalence and extent of gastric metaplasia and the amount of H. pylori in the duodenal bulb in the three patient groups were compared. The correlation between the amount of H. pylori in the duodenum and gastric antrum and extent of gastric metaplasia were also determined.
The prevalence and extent of gastric metaplasia and the amount of H. pylori in the duodenal bulb in patients with duodenal ulcer were much higher than in patients with gastric ulcer or chronic gastritis. A positive correlation was found between the amount of H. pylori in the duodenum and the extent of gastric bulb and that in the antrum.
The findings of this study indicate that H. pylori colonization in the duodenal bulb may play a critically important role in the pathogenesis of duodenal ulcer and that the amount of H. pylori in the duodenal bulb may be related to the amount of H. pylori in the gastric antrum and the extent of gastric metaplasia in the duodenal bulb.
本研究的目的是确定十二指肠黏膜中幽门螺杆菌的数量和胃化生程度在十二指肠溃疡发病机制中是否起关键作用。
从幽门螺杆菌阳性的十二指肠溃疡、胃溃疡或慢性胃炎患者中获取十二指肠和胃活检标本。使用亚甲蓝试验通过组织学和内镜检查评估胃化生程度。在本研究中，我们进行了竞争性聚合酶链反应，这是一种用于测定胃和十二指肠黏膜中幽门螺杆菌数量的高灵敏度定量方法。比较了三组患者十二指肠球部胃化生的发生率和程度以及幽门螺杆菌数量。还确定了十二指肠和胃窦中幽门螺杆菌数量与胃化生程度之间的相关性。
十二指肠溃疡患者十二指肠球部胃化生的发生率和程度以及幽门螺杆菌数量远高于胃溃疡或慢性胃炎患者。十二指肠中幽门螺杆菌数量与胃窦和胃球部的程度之间存在正相关。
本研究结果表明，十二指肠球部幽门螺杆菌定植可能在十二指肠溃疡发病机制中起至关重要的作用，并且十二指肠球部幽门螺杆菌数量可能与胃窦中幽门螺杆菌数量以及十二指肠球部胃化生程度有关。
