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[幽门螺杆菌、胃炎与消化性溃疡]

[Campylobacter pylori, gastritis and peptic ulcer].

作者信息

Hirschl A M, Stanek G, Rotter M, Pötzi R, Gangl A, Hentschel E, Schütze K, Holzner H J, Nemec H

出版信息

Wien Klin Wochenschr. 1987 Jul 17;99(14):493-7.

PMID:3630180
Abstract

In the course of routine gastroduodenoscopic examination of 218 patients bioptic mucosal specimens were examined bacteriologically for the presence of Campylobacter (C.) pylori. The organism was isolated from 52 out of 53 patients (98%) with duodenal ulcer, 7 out of 9 with gastric ulcer (78%), 24 out of 31 with mucosal erosions (77%), 10 out of 10 with duodenitis (100%), 16 out of 16 with chronic active gastritis (100%) and from 40 out of 73 patients (55%) with inactive chronic gastritis. By contrast, all specimens from 26 patients with endoscopically and histologically normal mucosa were negative for this bacterium. The rate of elimination of C. pylori from mucosal specimens was investigated as a first step towards studying the influence of antibiotic therapy upon healing of gastric and duodenal ulcers. For this purpose 30 patients with duodenal ulcers were treated either with ranitidine alone (15) or together with bacampicillin (15), which was shown to be highly active in studies with ampicillin in vitro. After 4 weeks the organism was still found in specimens from all patients treated with ranitidine alone, but also in 12 out of 15 patients given combined therapy. This result demonstrates that systemic antimicrobial chemotherapy with bacampicillin is insufficient to eradicate C. pylori from the stomach and the duodenum.

摘要

在对218例患者进行常规胃十二指肠镜检查的过程中,对活检的黏膜标本进行了细菌学检查,以检测幽门弯曲菌(C. pylori)的存在。该菌在53例十二指肠溃疡患者中的52例(98%)、9例胃溃疡患者中的7例(78%)、31例黏膜糜烂患者中的24例(77%)、10例十二指肠炎患者中的10例(100%)、16例慢性活动性胃炎患者中的16例(100%)以及73例非活动性慢性胃炎患者中的40例(55%)中被分离出来。相比之下,26例内镜和组织学检查黏膜正常的患者的所有标本中该菌均为阴性。作为研究抗生素治疗对胃和十二指肠溃疡愈合影响的第一步,对黏膜标本中幽门弯曲菌的清除率进行了研究。为此,30例十二指肠溃疡患者分别单独使用雷尼替丁治疗(15例)或与巴卡西林联合治疗(15例),在体外对氨苄西林的研究中已表明巴卡西林具有高活性。4周后,在所有单独使用雷尼替丁治疗的患者标本中仍发现该菌,在联合治疗的15例患者中的12例标本中也发现了该菌。这一结果表明,使用巴卡西林进行全身抗菌化疗不足以从胃和十二指肠中根除幽门弯曲菌。

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