Ruiz B, Correa P, Fontham E T, Ramakrishnan T
Department of Pathology, Louisiana State University Medical Center, New Orleans 70112, USA.
Am J Clin Pathol. 1996 Jan;105(1):96-101. doi: 10.1093/ajcp/105.1.96.
The association between the topographic distribution of Helicobacter pylori colonization, inflammation and atrophy of the gastric mucosa, and fasting gastric pH was studied in a population with high prevalence of multifocal atrophic gastritis. Increasing atrophy of the antrum was associated with decreasing H pylori colonization of the antrum itself, but increasing colonization of the corpus. Advanced atrophy was associated with high fasting gastric pH. However, after therapeutic eradication of H pylori, inflammation subsided and gastric pH decreased indicating improved acid secretion despite persistent atrophy. The authors propose that antral atrophy fosters the colonization of oxyntic mucosa by H pylori, thus impairing acid secretion and causing hypochlorhydria that may further promote colonization of the oxyntic mucosa. Eradication of H pylori significantly improves hypochlorhydria. It may restore acid secretion in most patients, regardless of the presence of atrophy, which is an effect that may be of great benefit in halting the process of gastric carcinogenesis.
在多灶性萎缩性胃炎高发人群中，研究了幽门螺杆菌定植的地形分布、胃黏膜炎症和萎缩与空腹胃pH值之间的关联。胃窦萎缩加重与胃窦本身幽门螺杆菌定植减少相关，但与胃体定植增加相关。重度萎缩与高空腹胃pH值相关。然而，在幽门螺杆菌治疗性根除后，炎症消退且胃pH值降低，表明尽管萎缩持续存在，但胃酸分泌有所改善。作者提出，胃窦萎缩促进幽门螺杆菌在胃体黏膜定植，从而损害胃酸分泌并导致胃酸过少，这可能进一步促进胃体黏膜的定植。根除幽门螺杆菌可显著改善胃酸过少。它可能恢复大多数患者的胃酸分泌，无论是否存在萎缩，这一作用可能对阻止胃癌发生过程大有裨益。
