Saita H, Murakami M, Yoo J K, Teramura S, Dekigai H, Takahashi Y, Kita T
Department of Geriatric Medicine, Faculty of Medicine, Kyoto University, Japan.
Dig Dis Sci. 1993 Jan;38(1):117-22. doi: 10.1007/BF01296782.
We examined the interrelationships among the degree of fundic mucosal atrophy, the prevalence of Helicobacter pylori in the gastric antrum, the gastric juice, and the duodenum with and without gastric metaplasia, in 20 duodenal ulcer patients and 20 non-duodenal ulcer patients. The detection rates of H. pylori in the antrum, the gastric juice, and the duodenum were significantly higher in duodenal ulcer patients (80%, 65%, and 60%) than in non-duodenal ulcer subjects (50%, 20%, and 5%). The frequency of H. pylori was significantly lower in the gastric juice (30%) and the duodenum (10%) in non-duodenal ulcer patients with antral H. pylori, compared with those in duodenal ulcer patients with antral H. pylori. All of seven patients with both gastric metaplasia and H. pylori infection in the duodenum had duodenal ulcer, whereas only 1 of 14 patients without either gastric metaplasia or H. pylori infection in the duodenum had duodenal ulcer. There was normal or mild atrophic mucosa in the fundus of duodenal ulcer patients with H. pylori in the antrum, whereas moderate or severe atrophic mucosa in non-duodenal ulcer patients with H. pylori gastritis. These results suggest that the preserved fundic mucosa, gastric metaplasia in the duodenum, and a greater load of H. pylori to the duodenum through the gastric juice may be prerequisites for the formation of duodenal ulcers.
我们对20例十二指肠溃疡患者和20例非十二指肠溃疡患者的胃底黏膜萎缩程度、胃窦幽门螺杆菌（Helicobacter pylori，H. pylori）感染率、胃液以及有无胃化生的十二指肠进行了相关性研究。十二指肠溃疡患者胃窦、胃液和十二指肠中H. pylori的检出率（分别为80%、65%和60%）显著高于非十二指肠溃疡患者（分别为50%、20%和5%）。胃窦有H. pylori感染的非十二指肠溃疡患者，其胃液（30%）和十二指肠（10%）中H. pylori的检出率显著低于胃窦有H. pylori感染的十二指肠溃疡患者。十二指肠既有胃化生又有H. pylori感染的7例患者均患有十二指肠溃疡，而十二指肠既无胃化生也无H. pylori感染的14例患者中仅有1例患有十二指肠溃疡。胃窦有H. pylori感染的十二指肠溃疡患者胃底黏膜正常或轻度萎缩，而患有H. pylori胃炎的非十二指肠溃疡患者胃底黏膜为中度或重度萎缩。这些结果表明，保留的胃底黏膜、十二指肠胃化生以及通过胃液向十二指肠输送更多的H. pylori可能是十二指肠溃疡形成的先决条件。
