消化不良患者的幽门螺杆菌与组织病理学发现

Helicobacter pylori and histopathological findings in patients with dyspepsia.

作者信息

Türkay Cansel, Erbayrak Mustafa, Bavbek Nükhet, Yenıdünya Sibel, Eraslan Elife, Kasapoğlu Benan

机构信息

Department of Gastroenterology, Fatih University, School of Medicine, Ankara, Turkey.

出版信息

Turk J Gastroenterol. 2011;22(2):122-7. doi: 10.4318/tjg.2011.0179.

DOI:10.4318/tjg.2011.0179

PMID:21796546

Abstract

BACKGROUND/AIMS: Although Helicobacter pylori infection has been reported to be more frequent in patients with dyspepsia, whether it should be treated in dyspepsia remains controversial. This study was carried out to compare the histopathological changes in Helicobacter pylori-positive and -negative dyspepsia patients.

METHODS

A total of 461 patients with Helicobacter pylori-positive dyspepsia seen in our institution were enrolled in the study. The control group was formed from 100 Helicobacter pylori-negative dyspepsia patients. Subjects underwent an upper gastrointestinal endoscopy, and biopsy specimens were taken from the gastric antrum and corpus. All of the cases were evaluated according to the Sydney classification, and the relation of Helicobacter pylori with chronic inflammation, atrophy, intestinal metaplasia, and activity was investigated by two pathologists.

RESULTS

Activity, inflammation and intestinal metaplasia were found in 10 (10%), 70 (70%) and 10 (10%) of Helicobacter pylori (-) patients, respectively, and the numbers increased with increasing Helicobacter pylori intensity when compared with Helicobacter pylori (+) patients (p<0.01, p<0.01 and p<0.05, respectively). Atrophy was found in 27 (5.5%) of all cases (in 10 Helicobacter pylori (-) patients and in 17 Helicobacter pylori (+) patients), but no significant relation was found with increasing Helicobacter pylori intensity (p>0.05). There was no significant difference between corpus alone or antrum alone Helicobacter pylori (+) and both corpus/antrum (+) patients in regards to the presence of activity, inflammation, intestinal metaplasia, and atrophy (p>0.05).

CONCLUSIONS

Determination of the degree of morphological changes accompanying Helicobacter pylori infection in dyspepsia is important in the follow-up and treatment of patients. As activity, inflammation and intestinal metaplasia increase with increasing Helicobacter pylori intensity in dyspepsia patients, Helicobacter pylori eradication treatment can be recommended in these patients.

摘要

背景/目的：尽管据报道幽门螺杆菌感染在消化不良患者中更为常见，但在消化不良患者中是否应进行治疗仍存在争议。本研究旨在比较幽门螺杆菌阳性和阴性消化不良患者的组织病理学变化。

方法

本研究纳入了在我院就诊的461例幽门螺杆菌阳性消化不良患者。对照组由100例幽门螺杆菌阴性消化不良患者组成。受试者接受了上消化道内镜检查，并从胃窦和胃体取活检标本。所有病例均根据悉尼分类法进行评估，两名病理学家研究了幽门螺杆菌与慢性炎症、萎缩、肠化生和活动性的关系。

结果

幽门螺杆菌阴性患者中，活动性、炎症和肠化生分别见于10例（10%）、70例（70%）和10例（10%），与幽门螺杆菌阳性患者相比，随着幽门螺杆菌感染强度增加，这些指标的数量也增加（分别为p<0.01、p<0.01和p<0.05）。在所有病例中，27例（5.5%）发现萎缩（10例幽门螺杆菌阴性患者和17例幽门螺杆菌阳性患者），但未发现与幽门螺杆菌感染强度增加有显著关系（p>0.05）。在活动性、炎症、肠化生和萎缩的存在方面，单独胃体或单独胃窦幽门螺杆菌阳性患者与胃体/胃窦均阳性患者之间无显著差异（p>0.05）。