Halme L, Kärkkäinen P, Rautelin H, Kosunen T U, Sipponen P
Fourth Department of Surgery, Helsinki University Hospital, Finland.
Gut. 1996 Mar;38(3):379-83. doi: 10.1136/gut.38.3.379.
The frequency of gastric Crohn's disease has been considered low. This study was undertaken to determine the prevalence of chronic gastritis and Helicobacter pylori infection in patients with Crohn's disease. Oesophagogastroduodenoscopy was performed on 62 consecutive patients suffering from ileocolonic Crohn's disease. Biopsy specimens from the antrum and corpus were processed for both histological and bacteriological examinations. H pylori antibodies of IgG and IgA classes were measured in serum samples by enzyme immunoassay. Six patients (9.7%) were infected with H pylori, as shown by histology, and in five of them the infection was also verified by serology. Twenty one patients (32%) had chronic H pylori negative gastritis (negative by both histology and serology) and one of them also had atrophy in the antrum and corpus. Granulomas were found in four patients. The characteristic appearance of H pylori negative gastritis was focal and mostly mild inflammation resembling the inflammatory changes seen in the gut in Crohn's disease. Patients with H pylori negative chronic gastritis had a significantly more active disease in their gut than those with normal gastric mucosa (p < 0.01). It is concluded that H pylori positive gastritis is rare, while H pylori negative gastritis is relatively common in patients with Crohn's disease. H pylori negative 'Crohn's gastritis' seems to be associated with active Crohn's disease.
胃克罗恩病的发病率一直被认为较低。本研究旨在确定克罗恩病患者中慢性胃炎和幽门螺杆菌感染的患病率。对62例连续性回结肠克罗恩病患者进行了食管胃十二指肠镜检查。取自胃窦和胃体的活检标本进行组织学和细菌学检查。通过酶免疫测定法检测血清样本中IgG和IgA类别的幽门螺杆菌抗体。组织学显示，6例患者（9.7%）感染了幽门螺杆菌，其中5例的感染也通过血清学得到证实。21例患者（32%）患有慢性幽门螺杆菌阴性胃炎（组织学和血清学均为阴性），其中1例胃窦和胃体也有萎缩。4例患者发现有肉芽肿。幽门螺杆菌阴性胃炎的特征性表现为局灶性，大多为轻度炎症，类似于克罗恩病肠道中所见的炎症变化。幽门螺杆菌阴性慢性胃炎患者肠道疾病的活动度明显高于胃黏膜正常的患者（p<0.01）。结论是，幽门螺杆菌阳性胃炎少见，而幽门螺杆菌阴性胃炎在克罗恩病患者中相对常见。幽门螺杆菌阴性的“克罗恩胃炎”似乎与活动性克罗恩病有关。
