Oberhuber G, Wuendisch T, Rappel S, Stolte M
Institute of Clinical Pathology, AKH, University of Vienna, Austria.
Pathol Res Pract. 1998;194(9):609-13. doi: 10.1016/S0344-0338(98)80095-2.
Chronic atrophic body gastritis may be induced by H. pylori. Results on the effect of H. pylori eradication therapy have been conflicting. Here, we report on the effect of eradication therapy on both body atrophy and inflammation in 7 patients. They presented with severe or moderate atrophy of the oxyntic mucosa and positive H. pylori histology (Warthin-Starry) and/or serology. Eradication was performed with a standard double or triple therapy regimen. At least 6 weeks after successful eradication therapy, patients underwent rebiopsy and histopathological evaluation of the gastric body. In all 7 patients, the grade of body gastritis improved significantly. Among the patients with severe atrophy before H. pylori eradication, 2 had normal mucosa, 3 low-grade atrophy, and one moderate atrophy after treatment. The one case with moderate atrophy before treatment had normal mucosa after H. pylori eradication. In addition, inflammatory infiltration of the mucosa cleared up in 6 cases and improved from severe to mild in one case after treatment. From these results, we conclude that in patients with histologically demonstrated H. pylori and/or positive H. pylori serology atrophic body mucosa can recover after successful eradication therapy.
慢性萎缩性胃体胃炎可能由幽门螺杆菌引起。关于幽门螺杆菌根除治疗效果的结果一直存在争议。在此,我们报告7例患者根除治疗对胃体萎缩和炎症的影响。这些患者表现为胃黏膜严重或中度萎缩,幽门螺杆菌组织学检查(沃辛-斯塔里染色)和/或血清学检查呈阳性。采用标准的双重或三重治疗方案进行根除治疗。在成功的根除治疗至少6周后,患者接受胃体再次活检和组织病理学评估。所有7例患者胃体胃炎的分级均有显著改善。在根除幽门螺杆菌前有严重萎缩的患者中,2例治疗后黏膜恢复正常,3例为轻度萎缩,1例为中度萎缩。治疗前有中度萎缩的1例患者在根除幽门螺杆菌后黏膜恢复正常。此外,6例患者治疗后黏膜炎症浸润消失,1例患者炎症从重度改善为轻度。根据这些结果,我们得出结论,对于组织学证实有幽门螺杆菌和/或幽门螺杆菌血清学阳性的萎缩性胃体黏膜患者,成功的根除治疗后黏膜可以恢复。