Sbeih F, Abdullah A, Sullivan S, Merenkov Z
Department of Medicine, King Fahad National Guard Hospital Riyadh, Saudi Arabia.
J Clin Gastroenterol. 1996 Apr;22(3):227-30. doi: 10.1097/00004836-199604000-00017.
Our objective is to evaluate endoscopically-diagnosed antral nodularity in adults and its relationship to lymphoid hyperplasia (LH) and Helicobacter pylori (HP). Antral biopsy specimens were studied for inflammation, presence of HP, and lymphoid follicles. Patients with marked functional dyspepsia or recurrent duodenal ulcers were given triple therapy (bismuth subcitrate, tetracycline, and metronidazole in the recommended doses for 2 weeks) to eradicate HP. Follow-up endoscopy and biopsies, at least 4 weeks after finishing treatment, were performed to assess eradication of HP and its effect on nodularity and LH. In all 25 patients (age range, 20-42 years) with antral nodularity, biopsy specimens were positive for HP. Twenty (80%) of subjects had lymphoid follicles; 13 of these 20 were given triple therapy. Eradication of HP was achieved in five cases (38%). Patients in whom HP was successfully eradicated showed improvement of their symptoms; antral nodularity subsided and there was marked regression of the lymphoid follicles. Antral nodularity with LH, reported to be unique to children, is not uncommon in adults and is induced by HP, eradication of which leads to regression of nodularity and LH in most cases. Low eradication rates achieved with metronidazole-based triply therapy is due, possibly, to primary resistance to metronidazole. Long-term follow-up of such patients is required to assess the evolution of these findings.
我们的目的是评估成人经内镜诊断的胃窦部结节及其与淋巴组织增生（LH）和幽门螺杆菌（HP）的关系。对胃窦活检标本进行炎症、HP存在情况及淋巴滤泡的研究。对有明显功能性消化不良或复发性十二指肠溃疡的患者给予三联疗法（次枸橼酸铋、四环素和甲硝唑，按推荐剂量服用2周）以根除HP。在完成治疗至少4周后进行随访内镜检查和活检，以评估HP的根除情况及其对结节和LH的影响。在所有25例有胃窦部结节的患者（年龄范围20 - 42岁）中，活检标本HP均呈阳性。20例（80%）受试者有淋巴滤泡；这20例中的13例接受了三联疗法。5例（38%）实现了HP根除。HP成功根除的患者症状有所改善；胃窦部结节消退，淋巴滤泡明显消退。据报道，伴有LH的胃窦部结节在儿童中较为独特，但在成人中并不少见，且由HP引起，根除HP在大多数情况下会导致结节和LH消退。基于甲硝唑的三联疗法根除率较低，可能是由于对甲硝唑的原发性耐药。需要对这些患者进行长期随访以评估这些发现的演变情况。
