Offerhaus G J
Johns Hopkins Hospital, Department of Pathology, Baltimore, Maryland 21205.
Ned Tijdschr Geneeskd. 1991 Apr 6;135(14):596-9.
The isolation of Helicobacter pylori from the human stomach has changed the insights into the mechanisms of chronic gastritis. The altered concepts are reflected in newly developed classification systems. In 1989 distinction of the types A, B and C of chronic gastritis was proposed as a working formulation. In this classification type A gastritis is an autoimmune disease with antibodies against parietal cells and intrinsic factor. It is limited to the body of the stomach and may be complicated by pernicious anaemia. Type B gastritis is related to bacterial infection by Helicobacter pylori and predominantly affects the antrum. It is associated with peptic ulcer disease. Type C gastritis is caused by chemical injury due to bile reflux and drugs. Especially NSAIDs are implicated. Each of these forms of gastritis has its histological counterpart. In 1990 the A, B, C terminology was overruled by the Sydney system, which recognises three forms of gastritis: acute, chronic and special forms and is otherwise mainly descriptive. The different classification systems are briefly discussed. It is concluded that uniformity in classification is most important since it will facilitate epidemiologic research of the natural history and long-term outcome of these diseases.
从人胃中分离出幽门螺杆菌改变了人们对慢性胃炎发病机制的认识。这些改变的观念反映在新制定的分类系统中。1989年，有人提出将慢性胃炎分为A、B、C型作为一种实用的分类方法。在这种分类中，A型胃炎是一种自身免疫性疾病，存在抗壁细胞和内因子的抗体。它局限于胃体，可能并发恶性贫血。B型胃炎与幽门螺杆菌的细菌感染有关，主要影响胃窦。它与消化性溃疡病有关。C型胃炎是由胆汁反流和药物引起的化学损伤所致。尤其是非甾体抗炎药与之相关。这些胃炎的每种类型都有其对应的组织学表现。1990年，A、B、C术语被悉尼系统取代，该系统认可三种胃炎形式：急性、慢性和特殊形式，其他方面主要是描述性的。本文简要讨论了不同的分类系统。得出的结论是，分类的一致性最为重要，因为它将有助于对这些疾病的自然史和长期转归进行流行病学研究。
