Boixeda D, Gisbert J P, Martín de Argila C, Cantón R, al-Mustafa A
Servicio de Gastroenterología, Hospital Ramón y Cajal, Madrid.
Rev Clin Esp. 1995 Apr;195(4):220-5.
Biopsy samples obtained by endoscopy to diagnose infection by H. pylori usually come from the antral region. Nevertheless, there are few reports documenting the prevalence of infection at duodenal level. OBJECTIVE. To investigate the prevalence of H. pylori infection in duodenal bulb in different endoscopic diagnosis. METHODS. 331 patients with the following endoscopic diagnosis were studied: normal appearance (n = 55), gastritis (87), gastric ulcer (49), duodenal ulcer (120), and duodenitis (20). At endoscopy, different samples from duodenal bulb were obtained (apart from gastric fundus, body and antrum), which were processed for microbiology (Gram stain and culture) and histology (hematoxilin-eosin). RESULTS. Patients with duodenal ulcer or duodenitis had the highest H. pylori infection rate at duodenal bulb (47.7% and 65%, respectively). Differences were significant when compared with normal appearance (14.5%; p < 0.001) and gastritis (25%; p < 0.05). In all patients with H. pylori at duodenal bulb this organism was also detected at antral region. CONCLUSIONS. 1) The highest prevalence rates for H. pylori infection in duodenal bulb were found in patients with duodenal ulcer or duodenitis. 2) Diagnosis of H. pylori infection should not be based on the duodenal bulb samples alone, as this sample yields high false-negative results.
通过内镜检查获取的用于诊断幽门螺杆菌感染的活检样本通常取自胃窦区域。然而，鲜有报告记录十二指肠部位的感染患病率。目的：调查不同内镜诊断下十二指肠球部幽门螺杆菌感染的患病率。方法：对331例有以下内镜诊断结果的患者进行研究：外观正常（n = 55）、胃炎（87例）、胃溃疡（49例）、十二指肠溃疡（120例）和十二指肠炎（20例）。在内镜检查时，从十二指肠球部获取不同样本（除胃底、胃体和胃窦外），并进行微生物学（革兰氏染色和培养）及组织学（苏木精 - 伊红染色）处理。结果：十二指肠溃疡或十二指肠炎患者的十二指肠球部幽门螺杆菌感染率最高（分别为47.7%和65%）。与外观正常者（14.5%；p < 0.001）和胃炎患者（25%；p < 0.05）相比，差异具有统计学意义。在所有十二指肠球部存在幽门螺杆菌的患者中，该菌在胃窦区域也被检测到。结论：1）十二指肠溃疡或十二指肠炎患者的十二指肠球部幽门螺杆菌感染患病率最高。2）幽门螺杆菌感染的诊断不应仅基于十二指肠球部样本，因为该样本会产生较高的假阴性结果。
