慢性胃炎及消化性溃疡诱生型一氧化氮合酶表达和Hp感染的意义

目的探讨一氧化氮在慢性胃炎及消化性溃疡发病机制中的作用，以及ＮＯ和Ｈｐ感染的关系．方法用免疫组化法对正常对照者６例，慢性胃炎５６例及消化性溃疡患者１６例的胃粘膜标本进行检测，观察ｉＮＯＳ表达强度．并用改良Ｇｉｅｍｓａ法同步检测Ｈｐ感染状况．结果ｉＮＯＳ染色定位于胞质，在正常人胃及十二指肠粘膜细胞和腺体均有表达．慢性浅表性胃炎组呈过度表达，其平均表达强度明显高于对照组及慢性萎缩性胃炎组（Ｐ＜００１）．慢性萎缩性胃炎组平均表达水平和对照组比较差异无显著性（Ｐ＞００５）．慢性胃炎组ｉＮＯＳ表达强度与其Ｈｐ分级间呈明显正相关（Ｐ＜００５）．消化性溃疡组平均表达水平较对照组增强（Ｐ＜００５），其ｉＮＯＳ表达强度和Ｈｐ分级间相关性不明显（Ｐ＞００５）．结论ｉＮＯＳ活性增强和过度表达可能在慢性胃炎和消化性溃疡的发病机制中发挥一定作用，并可能是Ｈｐ感染导致慢性胃炎的相关发病机制之一．

Expression of inducible nitric oxide synthase and Hp infection in chronic gastritis and peptic ulcer

AIM To observe the effect of iNOS in chronic gastritis and peptic ulcer in and to identify the relationship between iNOS expression intensity and Hp inflection. METHODS iNOS expression intensity in tissues of 56 patients with chronic gastritis, 16 patients with peptic ulcer and 6 normal controls was examined by immunohistochemical staining. Hp grades were determined synchronously by modified Giemsa stain. RESULTS Gastric and duodenal epithelial cells and crypts showed noticeable positive staining in normal controls. Overexpression was observed in patients with chronic superficial gastritis, its mean expression levels were significantly higher than those in controls and in chronic atrophic gastritis ( P <0 01). The mean expression levels in patients with chronic atrophic gastritis showed no significant differences compared with controls. There was a significant positive correlation between iNOS expression intensity and Hp grades in patients with chronic gastritis ( P <0 05). The mean expression levels in patients with peptic ulcer were significantly higher than those in normal controls ( P <0 05). CONCLUSION Enhanced iNOS activity in gastric and duodenal mucosa may contribute to the pathogenesis of chronic gastritis and peptic ulcer. Inducible generation of NO by inflamed gastric mucosa may be one of the mechanisms to explain the link between Hp infection and chronic gastritis.