Debongnie J C, Burette A, Glupczynski Y, De Prez C, De Koninck X, Donnay M
Service de Gastroentérologie, Clinique Saint-Pierre, Ottignies, Belgique.
Gastroenterol Clin Biol. 1996 Feb;20(1):15-9.
The aim of the study was to determine in a large group of patients with a gastric ulcer the differences between patients, ulcers and gastric mucosa as related to the presence or absence of Helicobacter pylori (H. pylori).
This prospective study evaluated 150 patients with a benign gastric ulcer. A patient was considered as H. pylori positive on the basis of a positive culture or the presence of gastritis and another positive diagnostic test for H. pylori (urease test, cytology, histology, serology).
One hundred and five patients were positive for H. pylori (70%) whereas 45 patients were not infected (30%). There were significant differences regarding the clinical characteristics of patients, the ulcer and the mucosa. H. pylori positive patients differed in terms of past history of ulcer (63 vs 12%), age (57 vs 50 years), sex (48% males vs 24%) and consumption of non steroidal antiinflammatory drugs (39 vs 75%). H. pylori positive ulcers were more often single (79 vs 53%) and located on the small curvature (76 vs 33%). Chronic gastritis was always present in positive patients, with associated intestinal metaplasia (35 vs 2%) and atrophy (45 vs 9%). Negative patients often had a normal gastric mucosa (53%) or reactive gastritis (27%).
Seventy percent of gastric ulcer are associated with H. pylori infection, corresponding to the classical ulcer. The majority of H. pylori negative ulcers appears to be associated to non steroidal antiinflammatory drugs.
本研究旨在确定一大组胃溃疡患者中，与幽门螺杆菌（H. pylori）感染与否相关的患者、溃疡及胃黏膜之间的差异。
这项前瞻性研究评估了150例良性胃溃疡患者。若培养结果为阳性，或存在胃炎且另一项幽门螺杆菌阳性诊断检测（尿素酶试验、细胞学检查、组织学检查、血清学检查），则该患者被视为幽门螺杆菌阳性。
105例患者幽门螺杆菌阳性（70%），而45例患者未感染（30%）。患者的临床特征、溃疡及黏膜方面存在显著差异。幽门螺杆菌阳性患者在溃疡既往史（63%对12%）、年龄（57岁对50岁）、性别（男性48%对24%）及非甾体抗炎药使用情况（39%对75%）方面有所不同。幽门螺杆菌阳性的溃疡更常为单发（79%对53%），且位于小弯侧（76%对33%）。阳性患者总是存在慢性胃炎，并伴有肠化生（35%对2%）和萎缩（45%对9%）。阴性患者常具有正常胃黏膜（53%）或反应性胃炎（27%）。
70%的胃溃疡与幽门螺杆菌感染相关，对应于经典溃疡。大多数幽门螺杆菌阴性溃疡似乎与非甾体抗炎药有关。
