Haruma K, Komoto K, Kawaguchi H, Okamoto S, Yoshihara M, Sumii K, Kajiyama G
First Department of Internal Medicine, Hiroshima University School of Medicine, Japan.
Am J Gastroenterol. 1995 Jul;90(7):1107-10.
To evaluate the degree of gastritis and the prevalence of Helicobacter pylori in Japanese patients with pernicious anemia (PA).
Histological assessment for mucosal atrophy and inflammation was performed in gastric biopsy specimens taken from 24 Japanese patients with PA and from 24 age- and sex-matched controls. The prevalence of H. pylori was evaluated by Giemsa staining and serum IgG antibodies. Serum gastrin and pepsinogens were determined by radioimmunoassay.
All patients with PA had severe fundic atrophic gastritis, and 17 (71%) also had antral atrophic gastritis. Thirteen (54%) of 24 age- and sex-matched controls had fundic atrophic gastritis, and 15 (62%) also had antral atrophic gastritis. Mucosal inflammation was identified in the fundus of all 24 patients and in 15 (62%) controls and in the antrum of 22 (92%) patients and 16 (67%) controls. H. pylori was not detected by Giemsa staining or serum IgG antibodies to H. pylori in any patient with PA but was present in 16 (67%) controls. Serum gastrin levels were significantly higher, and serum pepsinogen I, II, and the I/II ratio were significantly lower in patients than in controls (p < 0.001).
Our results confirm that H. pylori infection is infrequent in PA and is unlikely to be a factor in producing type A gastritis in PA.
评估日本恶性贫血（PA）患者的胃炎程度及幽门螺杆菌（Helicobacter pylori）感染率。
对24例日本PA患者及24例年龄和性别匹配的对照者的胃活检标本进行黏膜萎缩和炎症的组织学评估。通过吉姆萨染色和血清IgG抗体评估幽门螺杆菌的感染率。采用放射免疫分析法测定血清胃泌素和胃蛋白酶原。
所有PA患者均有重度胃底萎缩性胃炎，17例（71%）还伴有胃窦萎缩性胃炎。24例年龄和性别匹配的对照者中，13例（54%）有胃底萎缩性胃炎，15例（62%）还伴有胃窦萎缩性胃炎。24例患者的胃底均发现黏膜炎症，15例（62%）对照者也有；22例（92%）患者和16例（67%）对照者的胃窦发现黏膜炎症。通过吉姆萨染色或幽门螺杆菌血清IgG抗体检测，未在任何PA患者中发现幽门螺杆菌，但在16例（67%）对照者中发现。患者的血清胃泌素水平显著升高，血清胃蛋白酶原I、II及I/II比值显著低于对照者（p < 0.001）。
我们的结果证实，PA患者中幽门螺杆菌感染率低，不太可能是PA中A型胃炎产生的因素。
