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幽门弯曲菌的临床意义、流行病学及实验室诊断

[Clinical significance, epidemiology and laboratory diagnosis of Campylobacter pyloridis].

作者信息

Kasper G, Dickgiesser N

出版信息

Immun Infekt. 1986 Apr;14(2):58-62.

PMID:3710514
Abstract

In 1983, bacteriological examinations of gastric epithelium isolated a new species of bacteria, the so-called Campylobacter pyloridis. These bacteria were found in 50% of the gastroscopic examinations from patients with dyseptic disorders. C. pyloridis is a gram-negative curved bacterium. Up to now it has been found on the surface of the human gastric epithelium. C. pyloridis is rarely isolated from the healthy gastric epithelium. The gastric epithelium containing C. pyloridis mostly suffers from inflammatory infiltration or from pathological changes like chronic gastritis of type B. The route of infection is unknown. C. pyloridis has not yet been isolated outside of the human stomach. For laboratory diagnosis of a disease caused by C. pyloridis, the bacterium has to be isolated from gastric bioptic specimen. Another possibility is to check for high serum antibody levels against C. pyloridis. Direct microscopic examinations of gastric epithelium are also possible. The positive urease test is the main criterion to differentiate C. pyloridis from other human pathogenic campylobacter species. As therapeutic agents are recommended: bismuthates, amoxicillin, furazolidone and tinidazole. These agents are able to eliminate C. pyloridis from gastric epithelium and to fade away the gastritis.

摘要

1983年,对胃上皮进行细菌学检查时分离出一种新细菌,即所谓的幽门弯曲菌。在患有消化不良病症患者的胃镜检查中,50%发现了这些细菌。幽门弯曲菌是一种革兰氏阴性弯曲菌。到目前为止,它已在人胃上皮表面被发现。幽门弯曲菌很少从健康的胃上皮中分离出来。含有幽门弯曲菌的胃上皮大多患有炎症浸润或出现如B型慢性胃炎等病理变化。感染途径尚不清楚。幽门弯曲菌尚未在人胃之外被分离出来。对于由幽门弯曲菌引起的疾病的实验室诊断,必须从胃活检标本中分离出该细菌。另一种可能性是检测针对幽门弯曲菌的高血清抗体水平。对胃上皮进行直接显微镜检查也是可行的。阳性尿素酶试验是将幽门弯曲菌与其他人类致病性弯曲菌属区分开来的主要标准。推荐的治疗药物有:铋酸盐、阿莫西林、呋喃唑酮和替硝唑。这些药物能够从胃上皮中清除幽门弯曲菌并消退胃炎。

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