幽门螺杆菌相关性胃部疾病的病理变迁

目的：探讨幽门螺杆菌（Hp)清除与否与胃黏膜病理转归的关系。方法：191Hp感染的胃炎或溃疡病患者分别随机给予抗Hp或非抗Hp治疗，1年后复查胃镜，病理分型根据悉系统。结果191例患者中，慢性炎症1年后的炎症程度较1年前减轻（P＜0．05）。其中萎缩和肠化生的程度也较前减轻（P＜0．05），但活性动性炎症和蔼前后比较差异无显著性（P＜0．05）。根据1年后胃镜复查有无Hp清除分为两个队列，Hp清除列有107例，Hp未肖除列有84例，Hp清除列较未清除列1年后慢性炎症程度轻（P＜0．05）活动性炎症者少（P＜0．05）。对不疾病和不同的治疗分层后发现，Hp清除者的胃黏膜炎症程度总是较Hp未清除者轻（P＜0．05）。结论本研究提示，Hp感染与胃黏膜活动性炎症关系较为密切。Hp清除有利于胃黏膜炎症程度的减轻。

Pathological development of gastric mucosa in Helicobacter pylori related diseases

Objective To study relationship of Helicobacter pylori (H.pylori) eradication and pathological development of gastric mucosa among H.pylori related diseases. Methods One hundred and ninty one H.pylori infected patients were randomly given anti H.pylori or non anti H.pylori medications, and endoscopic examination was repeated one year after the treatment. Pathological classification was followed the Sydney system. Results Among 191 patients, degree of chronic inflammation of gastric mucosa had ameliorated ( P <0.05), so did in atrophy and intestinal metaplasia ( P <0.05), 107 patients had H.pylori eradicated, while 84 patients not eradicated. Compared with H.pylori non eradicated patients, H.pylori eradicated patients had their chronic inflammation of the gastric mucosa improved ( P <0.05) and cases with active inflammation reduced ( P <0.05). When stratified by different diseases and different treatments, H.pylori eradicated patients showed chronic inflammation of the gastric mucosa improved more compared with H.pylori non eradicated patients ( P <0.05). Conclusions Above results suggested that H.pylori infection is closely related with active inflammation of gastric mucosa; H.pylori eradication is of beneficial for the improvement of chronic inflammation of gastric mucosa.