Ogutu E O, Kang'ethe S K, Nyabola L, Nyong'o A
Department of Medicine, University of Nairobi, Kenya.
East Afr Med J. 1998 Feb;75(2):85-9.
One hundred and twenty consecutive patients above 12 years of age with dyspepsia were studied from June 1993 to September 1994. They underwent upper gastrointestinal endoscopy to find the mucosal lesions which were associated with their dyspeptic symptoms. At endoscopy gastric mucosal biopsies were taken in order to identify Helicobacter pylori (H. pylori) using three different techniques: culture, histology and the rapid urease test. Normal looking mucosa was the commonest single endoscopic finding, accounting for 34.2%, followed by gastritis 31.7% and duodenal ulcer 29.2%. However, when duodenal ulcers and gastric ulcers were put together, then peptic ulcer was the most prevalent finding accounting for 38.4%. Peptic ulcer was the most prevalent pathological finding in both young (less than 50 years) and older patients (50 years and above). Duodenal ulcer was more prevalent than gastric ulcer in the younger age group with a ratio of 5.8:1, however, the ratio in the older age group was 1:1. Gastric cancer was only found in patients aged 50 years and above, accounting for 17.4% of dyspeptic symptoms in this age group. Females were found to have more normal endoscopic findings than males (59.6%, versus 17.8% respectively). The difference being statistically significant (p < 0.001). All our cases of peptic ulcer disease had evidence of H. pylori infection while dyspeptic patients with normal endoscopic mucosal findings had H. pylori in 80.5% of cases. The difference in prevalence of H. pylori in the two groups was statistically significant (p < 0.001). Surprisingly, evidence of H. pylori in gastric cancer cases was very low in this study, being found in only 25% of patients.
1993年6月至1994年9月，对120例年龄在12岁以上的消化不良患者进行了研究。他们接受了上消化道内镜检查，以寻找与消化不良症状相关的黏膜病变。在内镜检查时，取胃黏膜活检组织，采用三种不同技术鉴定幽门螺杆菌（H. pylori）：培养、组织学和快速尿素酶试验。内镜检查最常见的单一表现是外观正常的黏膜，占34.2%，其次是胃炎占31.7%，十二指肠溃疡占29.2%。然而，将十二指肠溃疡和胃溃疡合并计算时，消化性溃疡是最常见的表现，占38.4%。消化性溃疡是年轻患者（小于50岁）和老年患者（50岁及以上）中最常见的病理表现。在较年轻年龄组中，十二指肠溃疡比胃溃疡更常见，比例为5.8:1，而在老年组中，该比例为1:1。胃癌仅在50岁及以上患者中发现，占该年龄组消化不良症状的17.4%。发现女性内镜检查正常表现的比例高于男性（分别为59.6%和17.8%）。差异具有统计学意义（p < 0.001）。所有消化性溃疡病病例均有幽门螺杆菌感染的证据，而内镜黏膜检查正常的消化不良患者中，80.5%有幽门螺杆菌感染。两组幽门螺杆菌感染率的差异具有统计学意义（p < 0.001）。令人惊讶的是，在本研究中，胃癌病例中幽门螺杆菌感染的证据非常少，仅在25%的患者中发现。
