Villani L, Fiocca R, Perego M, De Giacomo C, Trespi E, Alvisi C, Turpini R, Solcia E
Istituto di anatomia patologica, I.R.C.C.S. Policlinico S. Matteo ed Università di Pavia.
Pathologica. 1990 Nov-Dec;82(1082):707-17.
Helicobacter Pylori (HP) were found in 878 (73%) of 1205 patients undergoing upper G-I endoscopy with multiple biopsies for gastroduodenal diseases. HP were present in similar percentages among patients with active (89%) or healed (81%) peptic ulcer as well as in non ulcerous dyspeptics affected with gastritis (85%). 96% of active chronic gastritis were infected by HP as compared with 55% of quiescent gastritis. Antral gastritis was more frequently active in patients with ulcer diseases (76%) than in dyspeptic and asyntomatic patients (50%). Healed gastric and duodenal ulcers showed decreased incidence of active antral gastritis (69) as compared with active ulcers. Conversely body gastritis was more frequently active in healed (37%) than in overt (18%) duodenal ulcers. 95 histologically normal stomachs as well as 9 cases exhibiting type A gastritis were devoid of HP. High rates of infection were found in 610 cases of chronic gastritis without atrophy as well as in 151 atrophic antral (type B) gastritis. Cytoplasmic vacuolization and swelling of foveolar-superficial cells with adhering bacteria, micropapillae and microerosions were commonly found in HP-infected mucosa. In 16 of 19 children with type B chronic gastritis antibacterial therapy eradicated HP. This was followed by resolution or striking improvement of gastritis and disappearance of epithelial lesions.
在1205例因胃十二指肠疾病接受上消化道内镜检查并多次活检的患者中，878例（73%）检测出幽门螺杆菌（HP）。活动性（89%）或愈合期（81%）消化性溃疡患者以及患有胃炎的非溃疡性消化不良患者中，HP感染率相似。96%的活动性慢性胃炎患者感染HP，而静止期胃炎患者的感染率为55%。溃疡疾病患者的胃窦炎活动性（76%）高于消化不良和无症状患者（50%）。与活动性溃疡相比，愈合的胃溃疡和十二指肠溃疡患者的活动性胃窦炎发生率降低（69%）。相反，愈合期十二指肠溃疡患者的胃体炎活动性（37%）高于显性十二指肠溃疡患者（18%）。95例组织学正常的胃以及9例表现为A型胃炎的病例未检测到HP。610例无萎缩性慢性胃炎病例以及151例萎缩性胃窦（B型）胃炎病例的感染率较高。在HP感染的黏膜中，常见小凹表面细胞的细胞质空泡化、肿胀，伴有黏附细菌、微乳头和微糜烂。19例B型慢性胃炎儿童中，16例经抗菌治疗根除了HP。随后胃炎消退或明显改善，上皮病变消失。
