幽门螺杆菌与胃酸分泌

人类发现胃黏膜存在螺旋状微生物是在100多年前．然而直至1983年澳大利亚学者Warren和Marshall才成功分离出幽门螺杆菌（H．pylori．Hp）．并于1989年正式命名．从此引起了各学科学者的广泛关注。Hp能在胃极端酸性环境下长期定植．其自身抗酸机制和对胃泌酸功能的影响相当复杂。同为Hp感染．所造成的临床结局却各不相同．多数感染者表现为慢性胃炎，部分发展成更为严重的疾病如消化性溃疡和胃癌。这种矛盾的结果与Hp感染后对酸分泌作用密切相关．然而其对酸分泌的作用是相当复杂的。     

幽门螺杆菌相关性溃疡病胃酸分泌功能的研究

幽门螺杆菌（Ｈｐ）的致病因素是多方面的,有报道Ｈｐ感染可导致高胃酸分泌。我院对１９例Ｈｐ相关性溃疡病患者治疗前后的胃镜、Ｈｐ、空腹血清胃泌素（ＧＡＳ）、基础胃酸分泌量（ＢＡＯ）、最大胃酸分泌量（ＭＡＯ））、高峰胃酸分泌量（ＰＡＯ）进行了检测,并与Ｈｐ...     

胃粘膜相关淋巴组织淋巴瘤与幽门螺杆菌感染

胃粘膜相关淋巴组织淋巴瘤与幽门螺杆菌感染韩盛玺陈和平文锦杨红近来，越来越多的研究显示幽门螺杆菌（Ｈｐ）感染与胃粘膜相关淋巴组织（ＭＡＬＴ）淋巴瘤有关。本研究旨在用免疫组化方法对病理证实的１５例胃ＭＡＬＴ淋巴瘤进行分型并探讨其与Ｈｐ感染之间的关系。一、...     

幽门螺杆菌对胃酸分泌的影响

阐述急性及慢性Hp感染对胃酸分泌的影响并探讨Hp感染与胃酸分泌之间的相互作用在十二指肠溃疡发病中的地位及其机制。     

幽门螺杆菌对胃酸分泌的影响

阐述急性及慢性ＨＰ感染对胃酸分泌的影响并探讨ＨＰ感染与胃酸分泌之间的相互作用在十二指肠溃疡发病中的地位及其机制。     

细胞因子基因多态性和幽门螺杆菌相关性疾病

大多数幽门螺杆菌 (Hp)感染者仅存在慢性胃炎 ,但少数感染者可发展为消化性溃疡、胃黏膜相关淋巴组织(MALT)淋巴瘤或胃癌。Hp和宿主是一个相互作用的整体。首先 ,Hp必须历经进化上的改变才能在宿主的免疫反应下存活 ,毒力菌株在疾病的发展中起作用 ,但Hp毒力的强弱不能完全解释溃疡和胃癌的发生。其次是宿主因素 ,如宿主感染Hp时的年龄在一定程度上就影响宿主和Hp相互作用的结局。随着年龄的增长 ,胃、十二指肠溃疡的发病率逐渐上升。基因易感性同样也很重要 ,有家族史患者的胃溃疡、十二指肠炎和十二指肠溃疡发生的危险性高于无家族史…     

幽门螺杆菌感染与胰腺疾病

近年来，不断有证据表明幽门螺杆菌(H．pylori)感染不仅是慢性胃炎、消化性溃疡和胃癌的主要致病因素，而且也与许多胃肠外疾病有关。由于H．pylori感染可引起上消化道正常生理状况发生变化，而胰腺的外分泌功能与上消化道正常生理功能的关系又极为密切，故人们推测H．pylori感染与胰腺疾病之间可能存在着某种联系，并就此进行了一定的探讨，此文就该方面研究作简要综述。     

幽门螺杆菌动物模型应用进展

在幽门螺杆菌（Hp)研究中,动物模型应用于：（1）构建Hp相关疾病模型;（2）评价Hp疫苗作用,本文综述了Hp动物模型在以上两方面的应用进展。     

拉萨地区幽门螺杆菌感染情况调查

幽门螺杆菌（Hp）是引起慢性胃炎、消化性溃疡的重要因素，与胃癌、胃淋巴瘤、消化不良的发生亦有密切关系。由于拉萨地处高原地区，当地居民饮食习惯与内地有所区别。本研究旨在探讨拉萨地区Hp感染情况，为临床预防、治疗提供依据。     

幽门螺杆菌感染的诊疗策略

已有大量的资料表明,Hp感染为慢性活动性胃炎的主要致病菌,消化性溃疡的重要致病因素,与胃癌、胃MALT淋巴瘤的发生也有密切关系,WHO把Hp列为一类致癌物。因此Hp相关疾病及其诊断和治疗的研究具有重要的临床意义。目前Hp感染诊断方法很多,常用的也有6种之多,但没有一个既简易、价廉,准确性又高,且能满足不同情况需要的Hp感染的诊断方法;同样,Hp感染治疗方案也很多,一个理想的方案:Hp根除率≥90％、疗程短、副作用少、病人依从性好、治疗简单、效果持续不易复发、价格低廉仍在研究之中。鉴于此,为更有效地诊断和治疗Hp感染,有必要讲究策略。     

胃粘膜癌变过程中幽门螺杆菌感染与端粒酶活性的表达

目的分析不同病变胃粘膜端粒酶活性表达的差异,及其与Hp感染的关系,并探讨端粒酶活性表达、Hp感染和胃粘膜癌变的关系.方法应用TRAP测定172例内镜活检标本和45例胃癌手术标本的端粒酶活性,其中内镜活检标本正常胃粘膜10例、慢性浅表性胃炎46例、胃溃疡30例、慢性萎缩性胃炎68例、胃癌18例,手术标本高分化型胃癌8例、低分化型胃癌37例.同时用EIA检测Hp感染患者血清中Hp-CagA-IgG,并分析端粒酶活性的表达和Hp-CagA-IgG水平的关系.结果在172例内镜活检标本中,正常胃粘膜、慢性浅表性胃炎、慢性萎缩性胃炎伴0度、1度、2度肠化和胃癌组织的端粒酶阳性率分别为0%,0%,0%,25%,38%,89%.45例手术切除的胃癌组织和相应的非癌胃组织也展现了相似的结果.Hp检出情况,正常胃粘膜、浅表性胃炎、慢性萎缩性胃炎伴0度、1度、2度肠化Hp阳性率分别为0%,52%,60%,70%,75%.45例手术切除胃癌的非癌胃组织伴0度、1度、2度肠化的Hp感染强度分别为10.8±9.6,41.3±31.1,86.4±47.8个/50腺体.慢性浅表性胃炎患者的Hp-CagA-IgG抗体显著低于胃癌患者的Hp-CagA-IgG抗体水平(P＜0.01),22例Hp阳性的胃癌患者感染的Hp全部为CagA+株,其非癌胃粘膜有12例展现了端粒酶活性(55%);相反Hp阳性的22例慢性浅表性胃炎患者感染的Hp只有8例为CagA+株(36%),其胃粘膜均未展现端粒酶活性.结论正常胃粘膜和浅表性胃炎不表达端粒酶活性,萎缩性胃炎随肠化进展端粒酶活性表达增加,胃癌组织中端粒酶活性表达最高,阳性率达88%以上.在胃癌患者的非癌胃粘膜中端粒酶活性的表达与肠化程度、Hp感染强度呈平行关系,且感染的Hp多为CagA+株;而慢性浅表性胃炎感染的Hp多为CagA-株.端粒酶活性检测可以作为胃粘膜癌变的一个早期预测指标,CagA+的Hp感染可能是端粒酶重新激活的一个启动信号.     

Effect of age and Helicobacter pylori infection on gastric acid secretion

BACKGROUND: Whether gastric acid secretion decreases with age is still controversial. With the discovery of Helicobacter pylori, the association of this bacterium with gastric acid secretion has also been discussed. The aim of this study was to investigate the relationship between gastric acid secretion, age and H. pylori infection. METHODS: The presence of H. pylori infection, the grade of fundic atrophic gastritis (FAG), and gastric acid secretion were investigated in 280 subjects without localized lesions in the upper gastrointestinal tract. Helicobacter pylori infection was confirmed by Giemsa and immunohistochemical staining, and FAG of biopsy specimens was graded on a scale of 0-4. RESULTS: Both basal and maximal acid output decreased with age in H. pylori-positive subjects, while they did not change with age in H. pylori-negative subjects. Gastric acid secretion decreased with the progression of FAG. An age-correlated decrease in gastric acid secretion in H. pylori-positive subjects depended on an increasing prevalence of FAG with age. CONCLUSIONS: In the population studied, advancing age had no influence on gastric acid secretion in H. pylori-negative subjects. Gastric acid secretion decreases with age in H. pylori-positive subjects because of the increasing prevalence of FAG with age.     

Ghrelin and gastric acid secretion

Ghrelin, a novel growth hormone-releasing peptide, was originally isolated from rat and human stomach. Ghrelin has been known to increase the secretion of growth hormone （GH）, food intake, and body weight gain when administered peripherally or centrally. Ghrelin is also known to stimulate the gastric motility and the secretion of gastric acid. In the previous studies, the action of ghrelin on acid secretion was shown to be as strong as that of histamine and gastrin in in-vivo experiment. In the studies, the mechanism for the action of ghrelin was also investigated. It was shown that vagotomy completely inhibited the action of ghrelin on the secretion of gastric acid suggesting that vagal nerve is involved in the mechanism for the action of ghrelin on acid secretion. As famotidine did not inhibit ghrelin-in- duced acid secretion in the study by Masuda et al, they concluded that histamine was not involved in the action of ghrelin on acid secretion. However, we have shown that famotidine completely inhibited ghrelin-induced acid secretion and histidine decarboxylase （HDC） mRNA was increased in gastric mucosa by ghrelin injection which is inhibited by vagotomy Our results indicate that histamine is involved in the action of ghrelin on acid secretion. Furthermore synergistic action of gastrin and ghrelin on gastric acid secretion was shown. Although gastrin has important roles in postprandial secretion of gastric acid, ghrelin may be related to acid secretion during fasting period or at night. However, further studies are needed to elucidate the physiological role of ghrelin in acid secretion.     

慢性多灶萎缩性胃炎患者胃酸分泌与幽门螺杆菌感染及血清胃泌素的关系

目的 研究慢性多灶萎缩性胃炎(BAG)胃酸分泌与幽门螺杆菌(Hp)感染及血清胃泌素的关系.方法 将200例确诊的慢性胃炎患者根据病理结果分为轻度、中度、重度BAG组及对照组(非萎缩性胃炎组),监测各组患者24小时胃内pH值的变化情况,并检测其幽门螺杆菌及血清胃泌素的含量,各组间进行比较.结果 (1)150例BAG患者中,Hp感染阳性率70%,随着胃粘膜萎缩程度的加重,Hp感染阳性率逐渐上升;(2)各组间血清胃泌素值比较:轻度萎缩组与非萎缩性胃炎组比较差异无显著性(P＞0.05),其余各组问比较差异有显著性(P＜0.05;(3)各组pH值分析结果:BAC胃黏膜轻度萎缩时,pH≤2时间百分比较非萎缩性胃炎组升高,pH＞4时间百分比及pH平均值、pH中位值均较非萎缩性胃炎组降低,中度及重度萎缩时pH≤2时间百分比逐渐降低,pH＞4时间百分比及pH平均值、pH中位值逐渐升高.结论 BAG的发生与Hp感染有关,胃粘膜萎缩程度与Hp感染的严重程度有关;BAG胃黏膜轻度萎缩时,血清胃泌素含量无明显变化;中、重度萎缩时,血清胃泌素含量降低;BAc胃黏膜轻度萎缩时,胃酸分泌增多;随着胃黏膜萎缩程度的加重,胃酸分泌逐渐减少.     

Physical exercise and gastric acid secretion

The effects of physical exercise on the basal acid secretion of the stomach has been investigated in 10 healthy individuals and 16 hypersecretors with duodenal ulcer. The gastric basal secretion was collected during 3 hours; during the first hour the patient was at rest, during the second he realized a training exercise, according to Roskamm's formula, and in the third was at rest. While normal subjects showed a significative reduction of the acid secretion during the period of exercise, in the hypersecretory patients with ulcer the acid secretion increased significantly during exercise, from 4.25 +/- 1.52 mEq/h to 7.79 +/- 3.49 mEq/h; these figures reverted to normal values (5.45 +/- 2.21) during the recovery period. We comment the potential mechanisms of these differences in both groups of patients.