Boixeda D, Gisbert J P, de Rafael L, Alvarez Baleriola I, Martín de Argila C, Bermejo F, García Plaza A
Servicio de Gastroenterología, Hospital Ramón y Cajal.
Med Clin (Barc). 1995 Nov 4;105(15):566-9.
The aim of the present was to study the usefulness of performing biopsies of the gastric body in addition to those normally obtained of the antrum in the control of the eradication of Helicobacter pylori after treatment.
Sixty-four patients with duodenal ulcer and infection by H. pylori were prospectively studied. Two therapeutic schedules were used: amoxycillin/clavulanic associated with omeprazole (n = 32) and the classical triple therapy (bismuth, metronidazole, tetracycline) (n = 32). At the time of initial endoscopy and one month after completion of the treatment biopsies of the antrum and gastric body were taken for histologic (hematoxylin-eosin) and microbiologic (Gram and culture) studies. A patient was considered to have H. pylori infection when its presence was demonstrated by histologic or microbiologic methods in either of the localizations.
The eradication of H. pylori was globally achieved in 64% (n = 41) of the cases. In the patients in whom eradication was not achieved (n = 23), H. pylori was detected only in the antrum in 70% (30% false negatives) while this was seen in the gastric body in 96% of the cases (p < 0.05).
Carrying-out biopsies of only the antrum after eradicating H. pylori treatment is associated with a high percentage of false negative diagnosis of infection. Therefore, additional biopsies of the gastric body are recommended.
本研究的目的是探讨在治疗后幽门螺杆菌根除控制中，除了常规获取的胃窦活检外，进行胃体活检的有用性。
对64例十二指肠溃疡并感染幽门螺杆菌的患者进行前瞻性研究。使用了两种治疗方案：阿莫西林/克拉维酸联合奥美拉唑（n = 32）和经典三联疗法（铋剂、甲硝唑、四环素）（n = 32）。在初次内镜检查时以及治疗完成后1个月，采集胃窦和胃体的活检组织进行组织学（苏木精-伊红）和微生物学（革兰氏染色和培养）研究。当通过组织学或微生物学方法在任何一个部位证实存在幽门螺杆菌时，患者被认为感染了幽门螺杆菌。
总体上64%（n = 41）的病例实现了幽门螺杆菌的根除。在未实现根除的患者（n = 23）中，70%的患者仅在胃窦检测到幽门螺杆菌（30%为假阴性），而96%的病例在胃体检测到幽门螺杆菌（p < 0.05）。
根除幽门螺杆菌治疗后仅进行胃窦活检与感染的假阴性诊断比例较高相关。因此，建议额外进行胃体活检。
