Kokkola A, Sipponen P, Rautelin H, Härkönen M, Kosunen T U, Haapiainen R, Puolakkainen P
Second Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Aliment Pharmacol Ther. 2002 Mar;16(3):515-20. doi: 10.1046/j.1365-2036.2002.01214.x.
There are few data on the natural course of Helicobacter pylori-related atrophic gastritis.
To investigate the effect of H. pylori eradication on advanced atrophic gastritis in the corpus.
Twenty-two elderly men with H. pylori infection and moderate or severe atrophic corpus gastritis formed the study population. These men were under endoscopic surveillance because of the presence of indefinite or definite dysplastic gastric lesions in addition to atrophic corpus gastritis. The men were gastroscopically and bioptically examined four times before they received H. pylori eradication therapy (mean follow-up time, 7.5 years), and once again 2.5 years after eradication therapy. Serum levels of pepsinogen I and H. pylori antibodies were analysed at baseline, immediately before and 2.5 years after eradication therapy.
During the 7.5-year period prior to eradication therapy, no significant changes were observed in the mean atrophy and intestinal metaplasia scores or in the mean serum level of pepsinogen I. However, a significant improvement occurred in the mean histological scores of inflammation (from 2.2 to 0.5), atrophy (from 2.2 to 1.2) and intestinal metaplasia (from 1.6 to 1.1) in the corpus mucosa after H. pylori eradication. In addition, the mean serum level of pepsinogen I increased from 16.3 to 25.7 microg/L (P=0.0071, Wilcoxon signed rank test) after eradication therapy.
The results suggest that advanced atrophic corpus gastritis (and intestinal metaplasia) improves and may even heal after the eradication of H. pylori.
关于幽门螺杆菌相关萎缩性胃炎自然病程的数据较少。
研究根除幽门螺杆菌对胃体部重度萎缩性胃炎的影响。
22名感染幽门螺杆菌且患有中度或重度胃体萎缩性胃炎的老年男性构成了研究人群。除胃体萎缩性胃炎外，这些男性因存在不确定或明确的发育异常胃病变而接受内镜监测。在接受幽门螺杆菌根除治疗前（平均随访时间7.5年）对这些男性进行了4次胃镜和活检检查，根除治疗后2.5年再次进行检查。在基线、根除治疗前即刻以及根除治疗后2.5年分析血清胃蛋白酶原I水平和幽门螺杆菌抗体。
在根除治疗前的7.5年期间，平均萎缩和肠化生评分或胃蛋白酶原I平均血清水平均未观察到显著变化。然而，根除幽门螺杆菌后，胃体黏膜炎症（从2.2降至0.5）、萎缩（从2.2降至1.2）和肠化生（从1.6降至1.1）的平均组织学评分有显著改善。此外，根除治疗后胃蛋白酶原I的平均血清水平从16.3微克/升升至25.7微克/升（P = 0.0071，Wilcoxon符号秩检验）。
结果表明，根除幽门螺杆菌后，重度胃体萎缩性胃炎（和肠化生）有所改善，甚至可能痊愈。
