Collins J S, Knill-Jones R P, Sloan J M, Hamilton P W, Watt P C, Crean G P, Love A H
Royal Victoria Hospital, Belfast.
Ulster Med J. 1991 Apr;60(1):21-7.
The role of Helicobacter pylori infection in the symptom complex associated with non-ulcer dyspepsia is uncertain, despite the presence of the organism in a high proportion of these patients. In order to exclude physician bias in history taking, 18 patients (9 female) diagnosed as non-ulcer dyspepsia, after endoscopy and gallbladder ultrasonography, underwent computer interrogation using the Glasgow Diagnostic System for Dyspepsia (GLADYS). Five antral and 3 fundal endoscopic biopsies from these patients were also histologically examined for the presence of Helicobacter pylori and quantitatively analysed for polymorph and chronic inflammatory cell densities per mm2 of lamina propria using computer-linked image analysis. In the group of 9/18 patients who were positive for Helicobacter pylori, there were significantly higher antral and fundal inflammatory cell counts than in negative patients. However, analysis of the GLADYS interrogation data showed no significant positive relationships between Helicobacter pylori positivity and any gastrointestinal symptoms. These results confirm a significant association between Helicobacter pylori and superficial gastritis but suggest that non-ulcer dyspepsia in patients with Helicobacter pylori colonisation is probably not a clinically identifiable and distinct syndrome.
尽管在相当一部分非溃疡性消化不良患者中存在幽门螺杆菌感染，但该菌在与非溃疡性消化不良相关的症状复合体中的作用仍不明确。为排除医生问诊时的偏倚，18例（9例女性）经内镜检查和胆囊超声检查确诊为非溃疡性消化不良的患者，使用格拉斯哥消化不良诊断系统（GLADYS）进行了计算机问诊。还对这些患者的5块胃窦和3块胃底内镜活检组织进行了组织学检查，以检测幽门螺杆菌的存在，并使用计算机连接图像分析对固有层每平方毫米的多形核细胞和慢性炎症细胞密度进行定量分析。在18例患者中有9例幽门螺杆菌检测呈阳性，这些患者的胃窦和胃底炎症细胞计数显著高于阴性患者。然而，对GLADYS问诊数据的分析显示，幽门螺杆菌阳性与任何胃肠道症状之间无显著正相关。这些结果证实了幽门螺杆菌与浅表性胃炎之间存在显著关联，但表明幽门螺杆菌定植患者的非溃疡性消化不良可能并非临床上可识别的独特综合征。
