Fraser A G, Sim R, Sankey E A, Dhillon A P, Pounder R E
University Department of Medicine, Royal Free Hospital School of Medicine, London, UK.
Aliment Pharmacol Ther. 1994 Apr;8(2):167-73. doi: 10.1111/j.1365-2036.1994.tb00274.x.
Helicobacter pylori is associated with B-type gastritis, duodenal ulcer disease, and possibly gastric carcinoma. The object of this study was to assess the effect of eradication of H. pylori infection on gastric epithelial cell proliferation.
Gastric epithelial cell proliferation was assessed in 22 H. pylori-positive duodenal ulcer patients before and 6 weeks after 'triple therapy' with bismuth, tetracycline and metronidazole. Cell proliferation was studied either by immunostaining for the proliferating cell nuclear antigen (PCNA) or by a microdissection technique.
Eradication was successful in 10 of the 22 H. pylori-positive patients. Treatment with 'triple therapy' resulted in a significant fall in the rate of gastric epithelial cell proliferation; this effect was seen in both the gastric body and antrum. There was a significant correlation between the number of PCNA-labelled cells and the histological grade of activity (neutrophil inflammation) (r = 0.49, P = 0.02); the same correlation was found for the number of mitoses per gland (r = 0.5, P = 0.02). There was no significant difference in the treatment effect for eradicated or non-eradicated patients or either the body or antrum. Six patients, who had at least one antral biopsy that showed evidence of focal intestinal metaplasia, had a higher rate of cell proliferation.
The reduction in epithelial cell proliferation in the body and antrum after triple therapy is independent of successful eradication of H. pylori, and it may be due to an anti-inflammatory effect of triple therapy.
幽门螺杆菌与B型胃炎、十二指肠溃疡病以及可能的胃癌有关。本研究的目的是评估根除幽门螺杆菌感染对胃上皮细胞增殖的影响。
对22例幽门螺杆菌阳性的十二指肠溃疡患者在使用铋剂、四环素和甲硝唑进行“三联疗法”之前及之后6周评估胃上皮细胞增殖情况。通过对增殖细胞核抗原（PCNA）进行免疫染色或采用显微切割技术研究细胞增殖。
22例幽门螺杆菌阳性患者中有10例根除成功。“三联疗法”治疗导致胃上皮细胞增殖率显著下降；在胃体和胃窦均可见此效果。PCNA标记细胞数量与组织学活动分级（中性粒细胞炎症）之间存在显著相关性（r = 0.49，P = 0.02）；每个腺体的有丝分裂数量也存在相同的相关性（r = 0.5，P = 0.02）。根除或未根除的患者以及胃体或胃窦的治疗效果均无显著差异。6例患者至少有一次胃窦活检显示有局灶性肠化生证据，其细胞增殖率较高。
三联疗法后胃体和胃窦上皮细胞增殖的减少与幽门螺杆菌的成功根除无关，可能是由于三联疗法的抗炎作用。
