血清胃蛋白酶原与胃泌素17联合检测评估萎缩性胃炎胃黏膜病理改变的价值

目的 探讨慢性胃窦部萎缩性胃炎患者血清胃蛋白酶原I（PGI）、II（PGII）和PGI/PGII比值（PGR）及胃泌素17（G-17）在评估胃黏膜病理改变中的价值.方法 选取行胃镜检查经病理诊断确诊为慢性萎缩性胃炎（CAG）患者140例,ELISA定量检测PGI、PGII、G-17并计算PGR,黏膜病理变化包括炎性反应、活动性、萎缩、肠化生,每一参数病变程度分阴性、 轻 、中 、重等四个等级,统计分析各个病理参数不同程度变化间血清指标的差异.结果 黏膜不同炎性反应间PGI、PGII、G-17差异无统计学意义.黏膜活动性与非活动性组间PGII、PGR、G-17比较差异有统计学意义（P〈0.05）;重度萎缩比轻中度萎缩PGII、G-17显著降低（P〈0.05）;黏膜重度肠化生患者PGI、PGII、PGR、G-17均表达明显下降（P〈0.05）,其中G-17降低最显著.结论 慢性胃窦部萎缩性胃炎患者血清GPI、PGII与G-17水平可鉴别黏膜活动与否,同时这三项指标能较好反映黏膜萎缩与肠化生严重程度,可用于病情监测,有利于胃癌早期病变的及时发现.     

幽门螺杆菌根除与否与胃粘膜病理改变的关系

目的：探讨幽门螺杆菌（HP）相关性胃部疾病的病理变化。方法：76例H姝胃炎或消化性溃疡患者，分别随机给予抗HP或非抗HP治疗，1年后复查，胃镜并行病理学检查。结果：1年后复查，治疗组较未治疗组慢性炎症程度减轻（P＜0．05），其中萎缩和肠化生以及活动性炎症程度也较前减轻（P＜0．05）。结论：本研究提示HP与胃粘膜炎症及萎缩，肠化生程度较为密切。HP根除有利于胃粘膜病理的好转。     

胃上皮化生、幽门螺杆菌感染和十二指肠溃疡的关系研究

目的：幽门螺杆菌（Hp）是引起消化性溃疡的重要致病因素，十二指肠溃疡（DU）患者HP感染率约90％。正常情况下HP主要定植于胃型上皮，也有DU患者十二指肠可见胃上皮化生，可供HP定植引起溃疡形成。本研究是经胃镜检查确诊为活动期十二指肠溃疡患者，检测十二指肠胃上皮化生、HP感染的情况，并与胃溃疡（GU）、功能性消化不良（FD）患者资料进行对照。结论：本组资料表明：十二指肠球部HP的检出率在DU、GU、FD三组差异无显著性。DU、GU、FD组的十二指肠胃上皮化生检出率分别为57．9％、11．1％、16．7％，3组患者在十二指肠球部均可出现胃上皮化生，但DU组显著高于其他2组，推测胃上皮化生与DU组的发病有关。     

老年人消化性溃疡166例胃镜分析

目的了解我院老年人消化性溃疡（Pu）发病特点。方法分析166例老年人消化性溃疡胃镜报告结果。结果老年人PU的检出率为10.78％,男女之比为4.35：1;胃溃疡（GU）占62.65％,十二指肠溃疡（DU）占30.72％,GU与Du之比为2.08：1,复合性溃疡占6.62％,多发性溃疡占24.1％。结论老年人PU的患者男性多于女性,Gu多于DU,GU的好发部位是胃窦和胃角,DU的好发部位是十二指肠球前壁;PU的幽门螺杆菌（Hp）感染率为81.93％。     

幽门螺杆菌感染与慢性胃炎患者胃黏膜病理变化的相关性研究

目的探讨幽门螺杆菌(Hp)感染与慢性胃炎患者胃黏膜病理变化的相关性。方法选取慢性胃炎患者80例,均行Hp和胃镜检查。根据胃镜检查结果分为慢性萎缩性胃炎组(58例,其中胃窦胃体均萎缩患者18例,仅胃窦萎缩患者40例)和非慢性萎缩性胃炎组(22例)。观察两组Hp检查阳性率。分析Hp感染与病理特征的关系。结果慢性萎缩性胃炎Hp阳性率(70.69%)明显高于非慢性萎缩性胃炎患者(40.91%),差异有显著性(P0.05)。慢性萎缩性胃炎患者中胃窦胃体均萎缩患者Hp阳性率(88.89%)明显高于仅胃窦萎缩患者(62.50%),差异有显著性(P0.05)。随着炎症程度、活动性、肠化分级和萎缩程度分级升高,Hp阳性率显著升高(P0.01)。结论 Hp感染与慢性胃炎患者炎症程度、活动性、肠化分级和萎缩程度密切相关。     

幽门螺杆菌多部位检测与临床及组织学表现的关系

目的 观察幽门螺杆菌（Hp）与胃及十二指肠粘膜病理组织学表现之间的关系。方法 对60例慢性胃炎和22例十二指肠溃疡患者经胃镜分别从胃窦、胃体、十二肠球部取活检,进行组织学检测。结果 在活动性胃炎中无论是胃窦部或胃体部Hp检出率近100％,显著地活动性十二指肠球炎的球部Hp的检出率,胃窦部Hp总检出率及活动性上的发生率均显著高于胃体部及十二指肠球部。22例十二指肠球部溃疡Hp在球部的检出率为54％,显著低于其在胃窦部组织中Hp100％的检出率。结论 Hp感染是胃粘膜活动性炎症的重要原因,并以此为基础发展为重度粘膜炎及溃疡病,因此,对某些慢性胃炎患者应及早进行Hp根除治疗。     

236例消化性溃疡的发病特点及胃镜特征

本院1986年11月至1996年10月行胃镜检查1053例，其检出消化性溃疡(PU)236例，检出率224％；其中十二指肠溃疡(DU)190例，占805％；胃溃疡(GU)32例，占13．6％；二之比为59：1；复台性溃疡(CU)14例，占5.9％。PU中男164例，占69.5％，女72例，占30.5％；DU中男132例，占69.5％，女58例，占30.5％：男女之比为均为23：1。GU中男20例，占62.5％，女12例，占37.5％，男女之比17：1。CU中男12例，女2例，男女之比为6：1。DU30岁～39岁组最多，占37.4％。CU30岁～39岁组占43.8％，50岁以上占37．5％。CU40岁～59岁组占64.3％。春季、夏季、秋季、冬季PU发病分别为23.3％、17.8％、25.8％和33.1％。DU92．6％发生在十二指肠球部，球后溃疡占7.4％。位于球前壁、大弯、小弯和后壁的溃疡依次为43.5％、21.5％、20.9％和6.7％。GU部位：幽门前区和胃窦46.9％，胃角43.8％,胃体3.1％，胃底6.2％。CU中的胃溃疡数与十二指肠溃疡数之比为1.4：1；其胃部溃疡92.3％发生在胃角、胃窦和幽门前区；其十二指肠溃疡44.4％位于球前壁。DU中霜斑样溃疡占11.1％。PU的伴随疾病中，检出各类慢性胃炎71.6%;DU伴发疣状胃炎都13.7％。     

胃肠相关疾病中幽门螺杆菌感染与胃黏膜白细胞介素-8含量的关系

目的　研究各种胃肠疾病幽门螺杆菌 (Hp)感染情况及其与胃黏膜白细胞介素 8(IL 8)含量的关系。 方法　采用双抗体夹心酶联免疫吸附试验检测 10 2例Hp感染与非感染患者胃黏膜匀浆上清液中的白细胞介素 8含量 ,其中胃镜下黏膜正常者 5例 ,单纯性慢性胃炎 (CG) 2 5例 ,十二指肠球部溃疡 (DU) 36例 ,胃溃疡 (GU) 15例 ,胃癌(Gca) 2 1例。结果　 10 2例中有 6 0例感染了Hp(5 8.8% ) ,其中以十二指肠球部溃疡组Hp感染率最高 (88.9% ) ,明显高于其他组 (均P <0 .0 5 ) ,Hp感染者胃黏膜IL 8含量明显高于非Hp感染者 (P <0 .0 1) ;GU、Gca、DU、CG组胃黏膜IL 8含量均明显高于黏膜正常组 (均P <0 .0 5 ) ,GU、Gca、DU组又明显高于CG组 (均P <0 .0 5 ) ,而GU、Gca、DU组间比较差异无统计学意义 (均P >0 .0 5 ) ;同时发现中度胃炎黏膜IL 8含量明显高于轻度胃炎 ,活动性胃炎又明显高于非活动性胃炎 (均P <0 .0 5 )。结论　Hp感染者与非感染者胃黏膜IL 8含量存在差异 ,疾病组胃黏膜IL 8含量明显高于正常黏膜 ,并与胃炎炎症程度和活动性有一定相关性 ,推测IL 8可能参与了Hp相关性胃炎胃黏膜损伤机制     

疣状胃炎胃镜及病理结果分析

【目的】分析疣状胃炎（VG）的胃镜和病理表现及与幽门螺杆菌（Hp）感染的关系。【方法】回顾性分析2006年7月1日至2009年7月1日在本院消化内镜室做检查的465例VG患者的胃镜及病理结果。胃镜下观察VG的好发部位、个数、类型,取胃组织做病理检查,尿素酶试验检测HP感染。【结果】VG检出率为3．99％。392例（84．30％）疣状隆起≤10个,73例（15．70％）疣状隆起〉10个;成熟型146例（31．40％）,未成熟型319例（68．60％）;单发于胃窦部的最多,为374例（80．60％）,其次为同时发生于胃窦和胃角部,为81例（17．46％）;伴随的诊断最多的依次是十二指肠炎65例（13．98％）、消化性溃疡54例（11．61％）、反流性食道炎51例（10．97％）、胃息肉26例（5．59％）。HP阳性者262例（56．34％）,HP阴性者203例（43．66％）。232例患者做病理检查,其中肠上皮化生者93例（40．09Yo）,异型增生者30例（12．93％）,合并萎缩者18例（7．76%）。经统计学分析,成熟型和不成熟型疣状胃炎在肠化、萎缩和异型增生方面差异无显著性（P=0．1925）。【结论】VG多见于胃窦部,不成熟型多见,有相当的Hp感染率及相当的肠上皮化生、异型增生及萎缩比率。但成熟型与不成熟型疣状胃炎在肠化、萎缩和异型增生方面差异无显著性。     

德阳地区消化性溃疡的流行病学特点

目的：研究分析德阳地区消化性溃疡的流行病学特点,为其防治提供依据。方法：对我院2002年1月至2007年12月中经胃镜检查诊断为消化性溃疡的病例的年龄、性别、发病季节、溃疡部位、幽门螺杆菌感染和并发症进行回顾性统计分析。结果：共检出5820例消化性溃疡,其中十二指肠溃疡（DU）3696例,胃溃疡（GU）1558例,复合性溃疡（CU）566例。溃疡患者男女比例为2.56：1。胃溃疡患者平均年龄为47.82岁,比十二指肠溃疡患者大5.8岁。检出率以冬季最高（32.25%）,夏季最低（21.63%）,具有统计学意义（P〈0.01）。幽门螺杆菌感染阳性率为90.82%。结论：消化性溃疡的发生与季节、年龄、性别和部位相互有关,合并幽门螺杆菌感染者占绝大多数,并发症发生率低。     

Helicobacter pylori associated antral gastritis in peptic ulcer disease patients and normal healthy population of kashmir, India

Aim: To study the association of Helicobacter pylori infection with chronic antral gastritis in peptic ulcer disease patients and healthy population of Kashmir.Methods: 50 peptic ulcer patients (duodenal ulcer = 46, gastric ulcer = 2 and combined duodenal and gastric ulcer = 2) and 30 asymptomatic healthy volunteers were included in this study. Peptic ulcer was diagnosed on endoscopic examination. 4-6 punch biopsies were taken from gastric antrum in all the individuals and in case of gastric ulcer an additional biopsy was taken from the edge of the ulcer to exclude its malignant nature. Helicobacter pylori (H. pylori) organism was diagnosed using three different test methods, viz. Histology (using Giemsa Stain), Microbiology (Gram Stain) and Biochemistry (using one minute Endoscopy Room Test). Histological diagnosis of H. pylori was taken as the "gold standard" for the presence of H. pylori organism. Histological diagnosis of gastritis was made using Hematoxylin and Eosin Stain and the gastritis was classified as active chronic gastritis and superficial chronic gastritis.Results: Out of 30 peptic ulcer disease patients with associated antral gastritis, 27 (90%) were positive for H. pylori on histological examination (13 superficial chronic gastritis and 14 active chronic gastritis) whereas out of 8 healthy volunteers with histological evidence of chronic antral gastritis, H. pylori was observed in 7 individuals (87.50%) (4 active chronic gastritis and 3 superficial chronic gastritis).Conclusion: A highly significant association between H. pylori infection with chronic antral gastritis both in peptic ulcer disease patients and healthy volunteers of Kashmir was found in this study. Association between H. pylori infection and chronic gastritis was 90% in peptic ulcer group and 87.50% in healthy population (P<0.005).     

内镜下酚红喷洒染色诊断胃内幽门螺杆菌感染

目的：通过内镜喷洒酚红溶液,直接观察胃内颜色改变诊断胃内幽门螺杆菌感染。方法：14例慢性胃炎,11例消化性溃疡患者,于检查前1天的睡前服兰索拉唑30mg,内镜检查时从活检孔道将0．1％的酚红溶液与5％的尿素溶液喷洒于胃粘膜上,观察胃粘膜的颜色变化,分别取染色和非染色胃粘膜组织4块,2块做病检查,2块做细菌检查。结果：7例慢性胃炎胃粘膜染色,其中5例全胃染色,2例胃窦染色,9例消化性溃疡胃粘膜染色,其中2例全胃染色,5例胃窦染色,1例胃体染色,1例胃底染色。染色部位的病理检查、细菌培养（除1例因消化道出血连续3d静脉注射洛赛克40mg为阴性外）均阳性,未染色部位病理检查、细菌培养均阴性。结论：内镜下酚红喷洒染色可诊断胃内幽门螺杆菌感染。     

The clinical value of taking routine biopsies from the incisura angularis during gastroscopy

BACKGROUND AND STUDY AIMS: The incisura angularis is considered to be a typical site for Helicobacter pylori colonization, glandular atrophy, intestinal metaplasia, gastric ulcer, and gastric carcinoma. Our aim was to clarify whether it is necessary to biopsy the incisura angularis routinely during gastroscopy, in addition to obtaining biopsies of the corpus and antrum. PATIENTS AND METHODS: A total of 272 consecutive patients, with a mean age +/- SD of 53.8 +/- 15.5 years, had two biopsies taken from the angulus, two from the antrum, and two from the corpus of the stomach during routine upper gastrointestinal endoscopy. Histological specimens were examined according to the updated Sydney System for the classification and grading of gastritis. RESULTS: Of the 272 patients, 11 (4.0 %) showed chronic inflammation in the angulus biopsy only. Similarly, the angulus was the only biopsy site which showed neutrophil polymorph infiltration (or "activity") in two patients (0.7 %), intestinal metaplasia in 13 patients (4.7 %), atrophy in three patients (1.1 %), and H. pylori colonization in one patient (0.4 %). Dysplasia (intraepithelial neoplasia) was not found in any of the biopsied sites in any of the 272 patients. H. pylori was found in 39 of the 272 patients (14 %). Of the 272 patients, 120 patients showed abnormalities at the incisura angularis, 101 having gastropathy or erosions, and only 19 showing more specific macroscopic changes, the main ones being ulcer, ulcer scarring, and atrophy. Of the 152 patients with a normal-looking mucosa at the angulus, only six (3.9 %) showed the histological changes of chronic inflammation in the angulus alone. Similarly, the angulus was the only biopsy site which showed neutrophil polymorph infiltration in one patient (1/152, 0.7 %), and intestinal metaplasia in five patients (5/152, 3.3 %). Atrophy and H. pylori colonization were not seen exclusively at the angulus in any of the patients with a macroscopically normal-looking angulus. CONCLUSION: Based on our data, routine biopsy of the incisura angularis would provide little additional clinical information to that obtainable from antrum and corpus biopsies.     

Campylobacter pylori in chronic gastritis

Altogether 301 patients with duodenal, gastric and prepyloric ulcers and non-ulcer controls were examined to study whether the Campylobacter pylori is related to ulcer itself or to coexisting chronic gastritis. Histological sections from antral and body mucosa were stained according to Warthin-Starry, Giemsa and with hematoxylin-eosin. The Campylobacter pylori was strongly associated with chronic superficial gastritis in both ulcer and non-ulcer patients and in both antral and body mucosa. No differences were found in the frequency of Campylobacter-positive cases between ulcer patients and non-ulcer controls when the comparison was made within this category of chronic gastritis (p greater than 0.05). The gastric ulcer patients have more often than non-ulcer controls the Campylobacter pylori in atrophic body gastritis (p less than 0.001). The bacteria were only occasionally seen in normal mucosa.     

长春地区慢性胃病患者幽门螺杆菌感染状况调查

目的通过对本地区慢性胃病患者幽门螺杆菌（H.pylori）感染状况调查,了解本地区流行病学特点,为进一步阐明其与慢性胃病发生发展的关系提供理论依据。方法采用ELISA方法测定血清H.pyloriIgG抗体及CagA抗体;采取胃粘膜活检组织进行快速尿素酶试验,调查H.pylori感染情况,分析其与各种疾病的关系。结果1180例慢性胃病患者H.pylori感染率为67.11%,复合性溃疡、十二指肠溃疡、胃溃疡及慢性萎缩性胃炎感染率分别为90.9%、84.57%、83.96%和80.24%。与慢性浅表性胃炎相比差异有显著性。消化性溃疡、慢性萎缩性胃炎、胃癌和胃息肉患者血清Hp-CagA抗体的阳性率明显高于慢性浅表性胃炎（P〈0.05）。结论本地区慢性胃病患者H.pylori感染率高与多数地区的普通人群,H.pylori感染者尤其是CagA阳性者,更易发生慢性萎缩性胃炎、消化性溃疡及胃癌。     

Relationship of gastroscopic features to histological findings in gastritis and Helicobacter pylori infection in a general population sample

BACKGROUND AND STUDY AIM: Various gastroscopic features may be interpreted as signs of gastritis, but the significance of such features in relation to histomorphology is uncertain. The aim of this study was to determine how macroscopic findings were related to histomorphological changes and the presence of Helicobacter pylori in the gastric mucosa, in a sample of the general population. SUBJECTS AND METHODS: 488 adult individuals, randomly selected from a general population, were screened with gastroscopy and biopsy. The macroscopic features recorded were erythema (diffuse, spotty, linear), erosions, absence of rugae in the gastric corpus, and presence of visible vessels. Gastritis was classified microscopically according to the Sydney system. The presence of H. pylori was determined histologically and using the urease test on fresh biopsy specimens. RESULTS: The sensitivity and specificity of absence of rugae for moderate to severe atrophic gastritis in the gastric corpus were 67 % and 85 %, respectively. Corresponding values for severe atrophy were 90 % and 84 %. The sensitivity and specificity of the presence of visible vessels for moderate to severe atrophy in the corpus were 48 % and 87 %, and for severe atrophy the values were 80 % and 87 %, respectively. Considering the antrum, the sensitivity and specificity of the presence of visible vessels for moderate to severe atrophy was 14 % and 91 %, respectively. With regard to chronic inflammation (moderate to severe in the corpus or antrum), none of the features, alone or in combination, showed a sensitivity of more than 56 %. No endoscopic features (alone or in combination) showed a sensitivity of more than 57 % for H. pylori infection. CONCLUSIONS: Except for the absence of rugae and visible vessels in the gastric corpus, macroscopic features as observed during gastroscopy are of very limited value in the evaluation of whether or not gastritis or H. pylori infection are present. This is in accordance with most previous studies in patient populations, and it must be emphasized that the diagnosis of gastritis should be based on histological examination of the gastric mucosa.     

生长激素调素在幽门螺杆菌阳性的慢性胃炎患者胃窦黏膜中的表达

目的检测生长激素调素在幽门螺杆菌(Hp)阳性的慢性胃炎患者胃窦黏膜组织中的表达。方法随机选择门诊慢性胃炎患者18例,取胃窦黏膜组织,以快速尿素酶及改良Giemsa染色两种方法判断Hp感染。以逆转录聚合酶链式反应(RT-PCR)法检测标本中生长激素调素mRNA的表达。结果18例患者中,Hp阳性者10例,阴性者8例;10例Hp阳性患者中7例呈现生长激素调素的高表达,8例Hp阴性患者中仅3例呈现生长激素调素的低表达(P=0.004)。结论生长激素调素在Hp阳性的慢性胃炎患者胃窦黏膜中呈高表达,提示生长激素调素可能是介导Hp阳性的慢性胃炎患者胃肠功能紊乱的原因之一。     

东亚型幽门螺旋杆菌感染与胃癌发生的关系

目的 通过检测各部位慢性胃炎、胃溃疡、胃上皮内瘤变、胃癌幽门螺旋杆菌(Hp)感染情况,探讨河北省消化道肿瘤高发地区Hp感染,特别是东亚型幽门螺旋杆菌(EAS)感染与胃癌发生的关系.方法 依据国际最新悉尼系统分级标准和直观模拟评分法对慢性胃炎进行分级;分别应用Giemsa染色和免疫组织化学法检测贲门、胃体、胃窦3个部位Hp和EAS感染情况,分析Hp感染率、部位分布以及与胃癌发生的关系.结果 总体结果表明,慢性胃炎和胃溃疡中EAS阳性检出率分别为67.0%(138/206)、100.0%(12/12)明显高于上皮内瘤变43.8%(32/73)和胃癌21.7%(13/60)(P<0.05).进一步按病变部位分析贲门、胃体、胃窦和EAS阳性检出率,结果发现同一部位中慢性胃炎、胃溃疡、低级别上皮内瘤变、高级别上皮内瘤变、胃癌Hp和EAS阳性率差异无统计学意义(P>0.05).从慢性胃炎严重程度方面分析,中性粒细胞浸润程度、单核细胞浸润程度、萎缩程度、肠化生程度最严重部位均位于贲门,差异均有统计学意义(P<0.05).Hp密度最高部位位于胃体(P>0.05),但差异无统计学意义.Spearman相关性分析显示,在贲门、胃体、胃窦,Hp密度分别与中性粒细胞浸润程度、单核细胞浸润程度、萎缩程度、肠化生程度呈正相关(P均<0.05).结论 河北省消化道肿瘤高发地区ESA阳性检出率较高,其感染分别与中性粒细胞浸润深度、单核细胞浸润深度、萎缩程度、肠化生程度呈正相关,且在贲门处较易引起严重病变,贲门癌的发生与ESA感染密切相关.     

Helicobacter pylori-related cytokines influence gastric acid secretion and gastric mucosal inflammation in gastroduodenal ulcers

Helicobacter pylori(H. pylori) is an important pathogenic factor for gastroduodenal ulcers and gastric cancer. The level of gastric acid output may influence the outcome of those diseases. With low acid output, H. pylori can spread to the corpus of the stomach, resulting in progression to atrophic gastritis. It may cause an increased risk of gastric cancer and ulcer. In contrast, with high output, H. pylori is confined in the gastric antrum, which develops antrum-predominant gastritis. This may contribute to an increased risk of duodenal ulcer. It is well known that inflammatory cytokines including interleukin (IL)-1 beta, IL-8 and tumor necrosis factor alpha modulate gastric acid secretion. Therefore, the host immune response by the cytokines may cause these disparate pathways in gastric acid secretion.