Caselli M, Gaudio M, Chiamenti C M, Trevisani L, Sartori S, Saragoni L, Boldrini P, Dentale A, Ruina M, Alvisi V
School of Gastroenterology, University of Ferrara, Italy.
J Clin Gastroenterol. 1998 Jan;26(1):74-80. doi: 10.1097/00004836-199801000-00020.
We have studied the morphologic aspects of the duodenal bulb in relation to Helicobacter pylori infection in a large group of patients with endoscopically assessed duodenitis to learn more about the pathogenesis of nonspecific duodenitis (bulbitis) and to clarify the specific role of H. pylori. Eight duodenal biopsy specimens in the four quadrants of the first part of the bulb and four gastric antral biopsy specimens were taken in 208 patients. Specimens were fixed in formalin, or in glutaraldehyde, then slides were stained with hematoxylin and eosin, periodic acid-Schiff, and Alcian-Giemsa, and with toluidine blue for semithin sections. Duodenal histology revealed inflammation in 155 (74.5%) and H. pylori-like bacterial bodies in 153 (73.5%) of the patients; H. pylori infection in the gastric antrum was diagnosed in 173 (83.1%) of the patients. Distinguishing histologic aspects appeared to be related to the presence of H. pylori infection. We believe that the present histologic grading of duodenitis correlates better with the natural history of H. pylori infection in the duodenal bulb, and better fits the requirements of a modern classification than the classification commonly used in duodenitis. We conclude that the term H. pylori-linked bulbitis should be adopted as the proper term to identify the particular kind of duodenitis predisposing to peptic ulcer.
我们对一大组经内镜评估为十二指肠炎症的患者的十二指肠球部形态学与幽门螺杆菌感染的关系进行了研究，以进一步了解非特异性十二指肠炎症（球部炎）的发病机制，并阐明幽门螺杆菌的具体作用。对208例患者在十二指肠球部第一部四个象限取8份十二指肠活检标本及4份胃窦活检标本。标本用福尔马林或戊二醛固定，然后切片用苏木精-伊红、过碘酸-希夫和阿尔辛-吉姆萨染色，半薄切片用甲苯胺蓝染色。十二指肠组织学检查显示，155例（74.5%）有炎症，153例（73.5%）有幽门螺杆菌样菌体；173例（83.1%）患者胃窦有幽门螺杆菌感染。不同的组织学表现似乎与幽门螺杆菌感染的存在有关。我们认为，目前的十二指肠炎症组织学分级与十二指肠球部幽门螺杆菌感染的自然史相关性更好，比十二指肠炎症常用的分类更符合现代分类的要求。我们得出结论，“幽门螺杆菌相关性球部炎”这一术语应作为识别易患消化性溃疡的特定类型十二指肠炎症的恰当术语。
