幽门螺杆菌相关性十二指肠溃疡与胃肠激素的关系

目的探讨幽门螺杆菌(Hp)相关性十二指肠溃疡(DU)患者Hp根除前后胃粘膜及血中促胃液素(Gas)和生长抑素(SS)含量变化的意义。方法采用放射免疫分析法测定Hp相关性DU患者42例Hp根除前后及正常对照者20例胃粘膜及血中Gas和SS含量。结果Hp相关性DU的患者胃粘膜及血中Gas的含量明显高于Hp阴性患者(粘膜:ng/g,226±65vs380±98;血清:ng/L,107±33vs50±8),而Hp根除后Gas含量则明显下降,Hp阳性者SS的含量低于Hp阴性患者(粘膜:ng/L,11±2 vs 42±8;血浆:ng/L,5.6±1.2vs10.2±2.3),Hp根除后SS含量显著升高,Hp感染时胃粘膜炎细胞浸润程度对Gas和SS的含量亦有一定影响。结论Gas和SS与Hp相关性DU密切相关,是参与DU发病的重要因素之一。     

不同胃病患者血清、胃液、胃粘膜锌含量的测定

本文对消化性溃疡及慢性胃炎患者进行了血清、胃液、胃粘膜组织微量元素（Ｚｎ）含量测定及幽门螺杆菌检测。结果表明：消化性溃疡及慢性胃炎患者血清、胃液、组织Ｚｎ含量均比正常人明显降低（Ｐ＜０．００１）。胃内幽门螺杆菌感染者比非感染者胃液、组织微量元素Ｚｎ下降更为显者（Ｐ＜０．０５）。     

幽门螺杆菌感染患者胃窦粘膜IL-6和TNF-α水平变化及其意义

检测幽门螺杆菌（HP）感染胃炎患者胃窦粘膜体外培养上清液中白细胞介素-6（IL-6）活性和肿瘤坏死因子（TNF-α）的含量。结果表明:Hp阳性胃炎患者胃窦粘膜IL-6活性和TNF-α含量均明显高于Hp阴性患者和正常对照组;合并活动性胃炎患者胃窦部TNF-α含量也明显高于非活动性胃炎,但两者胃窦部IL-6活性却没有明显的差异。     

慢性胃炎儿童血清胃泌素水平与幽门螺杆菌感染的关系

有研究表明[1～ 2 ] ,血清胃泌素 (Gas)水平与幽门螺杆菌(Helicobacterpylori,Hp)感染有关。为探讨慢性胃炎儿童血清胃泌素水平与幽门螺杆菌感染的关系 ,我们测定了 5 0例慢性胃炎儿童血清胃泌素水平 ,其中 ,Hp感染阳性者 2 1例 ,Hp阴性者 2 9例 ,现将结果报告如下。材料和方法一、对象 :选择 2 0 0 1年 7月～ 2 0 0 3年 5月在我院儿科消化道门诊经胃镜及病理组织活检确诊为慢性胃炎患儿 5 0例(男 2 7,女 2 3) ,年龄 3～ 1 4岁 ,平均 6 7岁。其中 ,经病理组织活检及Giemsa染色检查 ,Hp阳性者 2 1例 ,Hp阴性者 2 9例。另选择 30例 (男 1…     

血清胃蛋白酶原和胃泌素水平与幽门螺杆菌相关性消化性溃疡的相关性评价

目的:研究血清胃蛋白酶原(Pepsinogen,PG)和胃泌素(Gastrin,G)水平与幽门螺杆菌相关消化性溃疡之间的关系.方法:分别选择我院2019年12月至2021年4月收治的105例幽门螺杆菌阳性消化性溃疡患者(阳性组),106例幽门螺杆菌阴性消化溃疡患者(阴性组)以及112例健康体检者(健康体检组),对三组受试者的血清胃蛋白酶原和胃泌素水平进行检测,分析检测结果的差异.结果:三组受试者比较,阳性组患者血清PGⅠ、PGⅡ、G-17水平明显高于阴性组与健康体检组(P<0.05).幽门螺杆菌消化性溃疡患者比较,阳性组中胃溃疡患者的血清PGⅠ、PGⅡ、G-17水平均高于阴性组中胃溃疡患者(P<0.05);阳性组中十二指肠溃疡患者的血清PGⅠ、PGⅡ、G-17水平均高于阴性组中十二指肠溃疡患者(P<0.05).Logistic多因素回归分析显示,血清PGⅠ、PGⅡ、G-17水平与幽门螺杆菌相关性消化性溃疡之间正相关(OR>1,P<0.05).结论:血清胃蛋白酶原、胃泌素水平与幽门螺杆菌相关性消化性溃疡之间存在相关性,可作为诊断幽门螺杆菌相关性消化性溃疡的重要危险因素.     

不同胃部患者血清,胃液,胃粘膜锌含量的测定

本文对消化性溃疡及慢性胃炎患者进行了血清、胃液、胃粘膜组织微量元素（Ｚｎ）含量测定及幽门螺杆菌检测。结果表明：消化性溃疡及慢性胃炎患者血清、胃液、组织Ｚｎ含量均比正常人明显降低（Ｐ〈０．００１）。胃内幽门螺杆菌感染者比非感染者胃液、组织微量元素Ｚｎ下降更为显者（Ｐ〈０．０５）。     

IL-1β、IL-6、p53与胃癌组织幽门螺杆菌感染的相关性分析

目的 探讨IL-1β、IL-6、p53与胃癌组织幽门螺杆菌(Hp)感染的相关性.方法 选取2016年6月至2017年10月期间我院收治的100例胃癌患者,根据检查结果Hp阳性有89例,Hp阴性有11例.选取同期体检健康者50例作为对照组.比较各组间血清IL-1β、IL-6、p53水平以及相关性.结果 胃癌组血清IL-1β、IL-6、p53水平显著高于对照组(P＜0.05).胃癌组Hp阳性率(89.0％)显著高于对照组(22.0％)(P＜0.05).Hp(+)胃癌组血清IL-1β、IL-6、p53水平显著高于Hp(-)胃癌组(P＜0.05).胃癌Hp感染密度3级患者血清IL-1β、IL-6、p53水平显著高于1级和2级(P＜0.05).经过Spearson相关性分析,IL-1β、IL-6、p53水平与胃癌Hp感染密度均呈正相关关系.结论 胃癌组织Hp感染可引起血清IL-1β、IL-6水平等炎性因子提高和抑癌基因p53的激活,并通过联合作用机制共同促进胃癌的发生、发展.     

血清Gs RIA在幽门Hp感染性疾病中的临床意义

目的 :探讨幽门螺旋杆菌 (Hp)感染性胃十二指肠疾病中胃泌素 (Gs)表达的临床意义及Hp感染与血清Gs水平的关系。方法 :用放射免疫分析对 4 6例Hp阳性患者及 33例Hp阴性的患者进行血清Gs测定 ,并观察Hp阳性患者Hp根除前后血清Gs的变化。 结果 :Hp阳性患者血清Gs的表达高于Hp阴性者 (p <0 0 5 ) ,Hp根除前血清Gs水平明显高于Hp根除后 (p <0 0 5 )。 结论 :Hp感染可引起血清Gs升高 ,Gs可作为Hp感染与否的一项指标     

胃十二指肠疾病时胃液表皮生长因子及CagA幽门螺杆菌感染的关系

为探讨胃液表皮生长因子（EGF）含量变化及幽门螺杆菌（Hp）感染与胃十二指肠疾病的相关性。以幽门螺杆菌感染阳性的78例消化性溃疡和61例慢性胃炎患者为研究对象,健康人20例作对照,观察胃液EGF含量变化与胃十二指肠疾病的相关性。结果发现,消化性溃疡和慢性胃炎患者胃液EGF含量分别为175．1±103．5ng／L和240．9±182．1ng／L,明显低于正常人,511.9±54．1ng／L,（均P＜0.01）。消化性溃疡患者EGF含量明显低于慢性胃炎患者,P＜0．01。具有CagA基因的Hp感染的消化性溃疡患者EGF含量明显低于慢性胃炎组,P＜0．05。表明胃液EGF含量与Hp感染有关,尤其是具有CagA基因的幽门螺杆菌感染。     

吸烟饮酒对胃部疾病幽门螺旋杆菌感染的影响

幽门螺旋杆菌（helicobacter pylori,Hp）是慢性胃炎、消化性溃疡、胃癌的主要致病因子之一。Hp阳性患者胃窦炎症活动性显著重于Hp阴性者,多数国家超过90%的十二指肠溃疡患者和将近70%的胃溃疡患者伴有Hp感染[1]。     

Helicobacter pylori non-cytotoxic genotype enhances mucosal gastrin and mast cell tryptase.

AIMS: To determine the association, if any, between H pylori genotype and the gastric mucosal variations in the levels of gastrin, somatostatin, tryptase, and histamine. METHODS: 49 patients affected by duodenal ulcer and 48 by non-ulcer dyspepsia were studied. To identify the H pylori genotype, the presence of the cagA gene and vacA alleles m1, m2, s1, and s2 were analysed by polymerase chain reaction. Gastrin, somatostatin, tryptase, and histamine were measured in antral mucosal biopsies. RESULTS: 57 patients were infected with H pylori (30 with duodenal ulcer and 27 with non-ulcer dyspepsia). Gastrin and tryptase were increased in patients with H pylori infection, although the variations were statistically significant only for gastrin; somatostatin and histamine were not influenced by H pylori infection. In patients with non-ulcer dyspepsia the absence of the cagA gene and the presence of vacA alleles s2 and m2 were associated with higher values of tryptase and to a lesser extent of gastrin. These associations were not found in patients with duodenal ulcer. CONCLUSIONS: The cagA negative s2m2 strain of H pylori may be less dangerous for the gastric mucosa than other H pylori strains since it enhances tryptase production by gastric mucosal mast cells; this enzyme is thought to stimulate tissue turnover and favour wound healing.     

Gastrin-producing cells of the stomach in duodenal ulcer before and after selective proximal vagotomy

Morphofunctional state of the gastrin-producing cells in the antral gastric mucosa depending upon the gastric secretion and serum gastrin was investigated in patients with duodenal ulcer before and after the selective proximal vagotomy (SPV). Morphometric analysis of the hormone containing granules in G-cells showed the increase of their functional activity after SPV. It was demonstrated that serum basal gastrin reflects morphofunctional state of the gastrin-producing cells. Functional capabilities of the gastrin regulation of the gastric secretion after the vagus denervation of the acid-producing part of the stomach must be taken into consideration in duodenal ulcer surgery.     

The prevalence of lymphoid follicles in Helicobacter pylori associated gastritis in patients with ulcers and non-ulcer dyspepsia.

AIMS--To determine the prevalence of lymphoid follicles in Helicobacter pylori positive and negative gastritis in antral and body type gastric mucosa in patients with non-ulcer dyspepsia (NUD), duodenal ulcer, or gastric ulcer; to correlate follicle presence with patient age; to evaluate the correlation between the prevalence of lymphoid follicles and active and inactive gastritis and its severity; and to assess the positive predictive value of lymphoid follicle prevalence with respect to H pylori infection. METHODS--Gastric biopsy specimens, graded according to the Sydney system, from 337 patients were studied. RESULTS--Lymphoid follicles occurred more often in antral mucosa (78%) than in body type mucosa (41%) and were observed in 85% of patients with H pylori positive gastritis. There was no significant difference between NUD and gastric and duodenal ulcer disease with regard to the presence of lymphoid follicles. The positive predictive value of the presence of lymphoid follicles in H pylori infection was 96%. Lymphoid follicles were more commonly observed in patients aged between 10 and 29 years. Lymphoid follicles were more frequently found in pangastritis of all subtypes than in antral gastritis and also in active gastritis than in inactive gastritis. The presence of lymphoid follicles correlated strongly with the degree and severity of gastritis. CONCLUSION--Lymphoid follicles are a constant morphological feature of H pylori associated gastritis.     

胃十二指肠溃疡患者血中生长抑素和胃泌素水平及其在不同状态下的变化

本文对55例胃十二指肠溃疡患者空腹血浆中SS、Gas水平作了测定,并就其在溃疡出血、幽门螺旋菌感染、H_2RA治疗后等多种状态下的进一步改变作了观察。结果表明溃疡病患者SS水平显著高于正常,并发出血、幽门螺旋菌感染、H_2RA治疗后,血中SS和Gas水平未受显著影响。     

Differences in surface-exposed antigen expression between Helicobacter pylori strains isolated from duodenal ulcer patients and from asymptomatic subjects

We have analyzed possible qualitative and quantitative differences in antigen expression between Helicobacter pylori strains isolated from the antrum and different locations in the duodenum of 21 duodenal ulcer (DU) patients and 20 asymptomatic subjects (AS) by enzyme-linked immunosorbent assay (ELISA) and inhibition ELISA. Almost all antral and duodenal strains grown in vitro expressed the N-acetyl-neuroaminyllactose-binding hemagglutinin, flagellins (subunits FlaA and FlaB), urease, a 26-kDa protein, and a neutrophil-activating protein. In 75% of both the DU patients and the AS, antral H. pylori strains expressed either the blood group antigen Lewis y (Le(y)) alone or together with the Le(x) antigen. However, duodenal H. pylori strains of DU patients expressed Le(y) antigen more frequently than corresponding strains of AS (P < 0.05). Presence of Le(y) on H. pylori was related to the degree of active duodenitis (P < 0.05). Duodenal H. pylori strains isolated from AS were significantly more often Lewis nontypeable than duodenal strains of DU patients (P < 0.01). Presence of H. pylori blood group antigen-binding adhesin (BabA) was significantly higher on both antral and duodenal strains isolated from DU patients than on corresponding strains isolated from AS (P < 0.05). BabA-positive duodenal H. pylori strains isolated from DU patients were associated with active duodenitis more frequently than corresponding strains isolated from AS (P < 0.01). Infection with H. pylori strains positive for Le(y) and BabA in the duodenum is associated with development of duodenal ulcer formation.     

Effects of duodenogastric reflux on gastrin cells, somatostatin cells and serotonin cells in human antral gastric mucosa

Duodenogastric reflux (DGR) has been found to give rise to a hypochlorhydria secondary to alkaline reflux. We investigated whether there is a link between DGR and the gastrin, somatostatin, and serotonin cell numbers and the granular content of gastrin, somatostatin, and serotonin in endocrine cells in human antral mucosa. We investigated 38 selected Helicobacter pylori-negative patients with visual primary excessive DGR in upper endoscopy and symptoms of epigastric pain and bile vomiting. Ten control patients were included in this study. None of the patients had peptic ulcer or had received any medication. Antrum (10 biopsies from five different zones: the lesser and major curvature, the anterior and posterior wall, and the pylorus) and corpus (two biopsies from major curvature about 10 cm below the cardia) biopsy specimens were collected for routine histology, as well as for light and electron immunohistochemistry. In patients without atrophy or intestinal metaplasia and in patients with mild atrophy or mild intestinal metaplasia, the number of gastrin and somatostatin cells was not different from that in controls. In moderate atrophy or moderate intestinal metaplasia, however, the number of gastrin and somatostatin cells decreased. Serotonin cell number was significantly higher in all patients with DGR as compared with controls. The mean somatostatin granular content was increased (3.6+/-0.2 vs. 3.2+/-0.1). In addition, lysosomes with engulfed somatostatin granules were found. The mean serotonin granular content was decreased (2.3+/-0.3 vs. 2.9+/-0.3), while the mean gastrin granular content remained unchanged (2.5+/-0.3 vs. 2.4+/-0.2). Ultrastructurally, the granules in serotonin-positive cells corresponded to the gastric variant or to the intestinal variant of serotonin cells. The endocrine cells were found to have few granules positive for serotonin. It is concluded that DGR inhibits somatostatin granular release, but stimulates both serotonin granular release and serotonin cell growth.     

Spectrotypic analysis of antibodies to Helicobacter pylori in patients with antral gastritis and duodenal ulcer.

AIMS--To investigate the anti Helicobacter pylori (H pylori) spectrotype associated with (a) antral gastritis and duodenal ulcer; (b) the H pylori eradicating treatment. METHODS--Spectrotypic analysis was performed by isoelectric focusing and reverse blotting (IEFRB) in a cross sectional study on sera from 70 patients with antral gastritis and duodenal ulcer. In addition, a longitudinal study was performed on 40 of these patients (20 with antral gastritis and 20 with duodenal ulcer) who underwent eradicating treatment. RESULTS--The cross sectional study showed that the oligoclonal spectrotype was present in 74% of antral gastritis patients and in 85% of duodenal ulcer patients. In only a minority of subjects (23% with antral gastritis and 3% with duodenal ulcer) was a polyclonal spectrotype observed. The longitudinal study showed a reduction in the intensity of the spectrotypic bands in 5/10 antral gastritis patients with eradicated H pylori as opposed to only 2/10 patients without eradication. A reduction was also observed in 6/11 eradicated v 0/9 non-eradicated patients with duodenal ulcer. Collectively, a reduction in the spectrotype was observed in 11/21 patients (52%) who--independently of the disease--underwent H pylori eradication, as opposed to 2/19 of the non-responder patients (10.5%). The polyclonal spectrotype was found exclusively in four patients with antral gastritis, all belonging to the group without eradication of H pylori after eradicating treatment. CONCLUSIONS--The anti H pylori oligoclonal spectrotype is the most common pattern observed in patients with antral gastritis and duodenal ulcer. After H pylori eradicating treatment the spectrotype does not change qualitatively, but the polyclonal pattern seems to be predictive of a poor response to eradication.     

Stimulation of gastrin and somatostatin secretion from the isolated rat stomach by bombesin

The role of bombesin in the regulation of gastrin and somatostatin secretion was examined using an isolated vascularly perfused rat stomach preparation. Bombesin caused a biphasic, dose-dependent increase in gastrin and bombesin secretion. Neither somatostatin nor gastrin secretion was inhibited by atropine. The maximal gastrin response to bombesin (198 +/- 75% above basal levels) was less than one-half the maximal response to methacholine (462 +/- 94%). It was postulated that the concomitant release of somatostatin, in part from antral mucosa, attenuated the gastrin response to bombesin; the notion was tested with somatostatin antiserum. A 50- to 100-fold excess of sheep somatostatin antiserum augmented significantly the maximal gastrin response to bombesin by 966% in the initial peak period and by 532% in the plateau period; the response in the plateau period was not significantly different from the maximal response to methacholine. Methacholine stimulated the release of gastric bombesin also, but the exact cellular origin of the peptide could not be ascertained. On the basis of these results and of the topography of antral bombesin neurons and somatostatin D cells, a model for the neural (via bombesin) and paracrine (via somatostatin) control of gastrin secretion within the antrum is proposed.     

大鼠实验性胃溃疡自愈期间胃窦粘膜G、D细胞变化的免疫组织化学研究

本实验用成年雄性Wistar大鼠53只,分为溃疡组、盐水对照组和正常对照组。在手术后4、10,14、21及28天分批取材。用Sternberger PAP法进行免疫组织化学染色,分别显示胃窦粘膜胃泌素细胞(G细胞)和生长抑素细胞(D细胞),观察大鼠实验性胃溃疡自愈期间,G和D细胞的形态变化,并进行了细胞计数和统计学分析。本文结果表示,溃疡组G细胞数量在术后10至14天明显增多(P<0.01),21、28天趋于减少,但仍高于对照组。有些G细胞排列成群,密集呈明显带状。正常时G细胞分布在幽门腺的中、下1/3处,而溃疡组可见有些G细胞分布在腺的上部。D细胞数量仅在术后10天增多(P<0.01),与正常对照组相比差异显著。用免疫组织化学双重染色法,可见G细胞和D细胞之间存在着形态上的接触。溃疡自愈期间,G/D细胞比值未见明显改变。本实验结果提示,胃窦粘膜局部G、D细胞的变化和大鼠实验性胃溃疡自愈修复之间有着一定的联系。