Pimanov Sergey I, Makarenko Elena V, Voropaeva Alla V, Matveenko Maya E, Voropaev Eugen V
Therapy Department No. 2, Vitebsk State Medical University, Vitebsk, Republic Belarus.
J Gastroenterol Hepatol. 2008 Nov;23(11):1666-71. doi: 10.1111/j.1440-1746.2007.04983.x. Epub 2007 Jun 7.
The aim of this study was to assess the gastric histopathology and serum gastrin-17 and pepsinogens profiles in patients with duodenal ulcer before and after Helicobacter pylori eradication in a population with a very high prevalence of H. pylori. At the same time we assessed the role of H. pylori density on these variables.
Eighty Caucasian patients with H. pylori-associated duodenal ulcer before treatment and 1 year after randomized eradication were studied. Among patients with unsuccessful eradication two groups were distinguished according to the data obtained after treatment: the group with negative rapid urease test and decreased bacterial density according to morphological score (partial elimination group); the group with positive rapid urease test and high bacterial density (failed eradication group).
One year after successful eradication, serum levels of gastrin-17, pepsinogen I and pepsinogen II decreased. Similar changes of serum pepsinogen I and pepsinogen II levels were observed in patients with partial elimination of H. pylori infection. In the group with successful eradication, inflammation, activity, atrophy and number of lymphoid follicles in the antral mucosa fell. In the group with partial elimination, antral mucosa activity and H. pylori score reduced. Other morphological changes were statistically non-significant.
Patients with duodenal ulcer after successful eradication have improvement of morphological and functional characteristics of gastric mucosa.
本研究旨在评估幽门螺杆菌(H. pylori)高流行率人群中十二指肠溃疡患者在根除H. pylori前后的胃组织病理学、血清胃泌素-17和胃蛋白酶原水平。同时,我们评估了H. pylori密度对这些变量的作用。
对80例治疗前及随机根除治疗1年后的H. pylori相关性十二指肠溃疡白种患者进行研究。在根除治疗失败的患者中,根据治疗后获得的数据分为两组:快速尿素酶试验阴性且根据形态学评分细菌密度降低的组(部分清除组);快速尿素酶试验阳性且细菌密度高的组(根除失败组)。
成功根除1年后,血清胃泌素-17、胃蛋白酶原I和胃蛋白酶原II水平下降。在H. pylori感染部分清除的患者中也观察到血清胃蛋白酶原I和胃蛋白酶原II水平有类似变化。在成功根除组中,胃窦黏膜的炎症、活动性、萎缩及淋巴滤泡数量减少。在部分清除组中,胃窦黏膜活动性及H. pylori评分降低。其他形态学变化无统计学意义。
十二指肠溃疡患者成功根除H. pylori后,胃黏膜的形态和功能特征得到改善。