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）。     

儿童幽门螺杆菌感染与体内钙、铁、锌、镁、铜含量的关系

目的探讨幽门螺杆菌（H.pylori,HP）感染对儿童全血中钙、铁、锌、镁、铜含量的影响。方法应用酶联免疫法对有上消化道症状的患儿进行血清HP抗体测定及火焰原子吸收光谱法检测全血中钙、铁、锌、镁、铜含量,以χ2分析HP感染者与非感染者全血中钙、铁、锌、镁、铜含量的差异。结果HP感染患儿全血锌、全血铁含量明显低于非感染者。差异有显著意义。结论幽门螺杆菌可引起儿童血锌、铁含量降低,及时给予治疗,纠正锌、铁的不足,保证儿童锌、铁营养对儿童生长发育具有重要意义。     

不同胃病患者外周血T淋巴细胞亚群的测定结果

应用流式细胞仪（ＦＣＭ）检测外周血Ｔ淋巴细胞亚群ＣＤ３＾＋，ＣＤ４＾＋、ＣＤ８＾＋及ＣＤ４＾＋／ＣＤ８＾＋比值。健康人（志愿献血者）２０例，消化性溃疡３０例，萎缩性胃炎３０例，慢性浅表性胃炎３０例。结果表明：消化性溃疡、萎缩性胃炎患者Ｔ淋巴细胞亚群ＣＤ３＾＋、ＣＤ４＾＋均值明显低于健康人（Ｐ〈０．０１）。消化性溃疡患者ＣＤ＾８＋明显高于健康人（Ｐ〈０．０５），浅表性胃炎患者与健康人比Ｔ细胞亚群无明     

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。     

HP感染者部分胃肠激素的变化及意义

近年大量研究证实幽门螺杆菌(HP)与慢性胃炎和消化性溃疡密切相关,但是其确切的致病机理目前尚不明了。然而HP感染导致部分胃肠激素分泌紊乱在其致病中起一定作用。本文检测了HP感染者血清/浆及胃粘膜内胃泌素(GAS)和生长抑素(SS)含量,以探讨HP感染在胃炎及消化性溃疡中的致病作用。     

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。     

四联疗法治疗消化性溃疡的疗效评价

目的探讨四联疗法对消化性溃疡的治疗作用及根除幽门螺杆菌的效果。方法将102例胃镜证实为消化性溃疡者随机分为3组,A组48例给予三九胃泰2.5g 雷尼替丁150mg 阿莫西林500mg 甲硝唑400mg,bid;B组31例给予铋剂220mg 雷尼替丁150mg 阿莫西林500mg 甲硝唑400mg,bid;对照组(C组,23例)给予雷尼替丁150mg 阿莫西林500mg 甲硝唑400mg,bid;以上药物除抗菌药物只服用2周外,其余药物服至6周末疗程结束,第7周复查胃镜和/或13C呼气试验。结果溃疡总愈合率A组、B组、C组分别为90.9%、100%、86.4%,S2获得率分别为68.2%、73.1%和45.5%,Hp根除率分别为73.3%,76.1%和52.6%,症状缓解率大致相似,3组均无明显不良反应发生。结论雷尼替丁三联疗法加用铋剂和三九胃泰均可使S2获得率增加,同时Hp根除率上升,临床观察无明显不良反应。     

幽门螺杆菌感染者血清NO检测的临床意义

198 2年Marshall和Warren从慢性活动性胃炎患者的胃粘膜中分离出幽门螺杆菌(HP)之后,HP与上消化道疾病之间的关系倍受关注。现已确认其是慢性胃炎的主要致病因子,且与消化性溃疡的发病密切相关,根除HP之后可以显著降低或防止溃疡复发[1 ] 。一氧化氮(NO)是由血管内皮细胞释放,起到调节血压、传递神经信息作用的一种物质。近年来研究表明,NO除参与调节血管、神经系统外,还对免疫系统起作用,是一种新的免疫分子炎性介质[2 ] 。本文对6 0例慢性胃病患者血清NO含量进行测定,以探讨血清NO水平变化与胃粘膜幽门螺杆菌感染关系。1　材料和方…     

血清胃泌素测定应用于抗幽门螺杆菌疗效监测的研究

目的:为探讨十二指肠溃疡(DU)患者血清试餐胃泌素(MSG)对幽门螺杆菌(HP)感染的反应,评估抗HP治疗后MSG的降低水平及其用于判定HP根除效果的可靠性.方法:采用自身对照的方法对84例HP阳性DU患者进行了前瞻性研究,治疗前行胃镜检查,钳取胃窦粘膜,在进行组织学检查的同时,分别进行HP培养、改良Giemsa染色及快速尿素酶试验,并测定其血清MSG浓度,然后给予患者抗HP三联药物治疗(德诺120mg、羟氨苄青酶素500mg、甲硝唑200mg,4次/天×14天),停药4周后,再次重复上述检查(加做胃体粘膜活检),结果进行统计学处理,并另取同期16例轻度慢性胃炎HP检查阴性者进行空白对照.结果:DU组血清MSG浓度(165.0±85.6pg/ml)较对照组(48.9±14.3pg/ml)明显升高(P<0.001),但经治疗后,HP被根除者MSG明显下降门(73.5±44.6pg/ml,下降度为53.8%±16.5%,与治疗前比较差异有非常显著性(P<0.001).HP未根除者MSC下降不明显(134.8±91.4pg/ml),下降度仅为11.4±17.8%,与治疗前比较差异无显著性(p>0.05),如果选择MSG下降度≥30%为界值,预测HP治疗效果,与HP培养、病检及尿素酶方法比较,其敏感性为89.7%,特异性为93.8%、符合率为90.5%.结论:HP感染可引起DU患者血清MSG升高,HP根除后则迅速下降,其一定的下降度可能对判定HP根除是一可靠的、元创性     

Assessment of different methods for staining Helicobacter pylori in endoscopic gastric biopsies

The recent implication of Helicobacter pylori in the pathogenesis of gastritis-peptic ulcer syndrome and its relevance for the development of upper gastrointestinal malignancy warrant efficient methods for the detection and demonstration of the organism in biopsy specimens. We have compared 5 staining methods, namely, haematoxylin and eosin (H & E), immunohistochemistry (IHC), the silver staining HpSS, the alcian yellow-toluidine blue (Leung) method (A-Y) and Genta staining, for the demonstration of the organism in gastric biopsies taken from antrum, body and fundus of 118 patients who presented to our hospital with upper gastrointestinal symptoms. We found no significant differences in the efficacy of H & E, IHC, HpSS and A-Y in the demonstration of H. pylori in all 3 gastric sites. The least reproducible stain in our hands was the Genta stain. We conclude that H & E is adequate for the initial assessment of gastric biopsies in symptomatic upper gastrointestinal patients. This is because it is a well-tested, cheap and easy staining method, requiring a relatively short period of time to perform, with highly reproducible results. It has an added advantage of enabling simultaneous assessment of morphological changes accompanying H. pylori infection. When the density of the organism is expected to be low, we recommend addition of HpSS staining because of its high sensitivity and low cost. The disadvantages of the other staining methods (IHC, A-Y and Genta) are discussed.     

检测胃癌患者血清与胃液中MGdl-Ag的诊断价值

将外源性凝集素刀豆素A包被于ELISA板上,与检测血清或胃液反应后,封闭,用单抗MGd1-酶标SPA检测,以探讨鼠抗人胃癌单抗MGd1相应抗原(MGd1-Ag)在胃癌诊断中的意义。共检测血清183份(胃癌患者142例,正常人41例),胃液97份(胃癌患者72例,良性胃病患者25例)。结果显示:在118例未手术胃癌患者中,阳性58例,占49.2％;而24例胃癌切除术后患者中阳性4例,占16.7％;正常人阳性者为24.0％。胃癌患者胃液阳性率为41.7％,而良性胃病患者仅为4.0％。实验结果提示血清、胃液之中MGd1-Ag的检测对胃癌具有一定的诊断价值。     

幽门螺杆菌感染对中老年胃溃疡患者心理状态的影响

目的:探讨幽门螺杆菌感染对中老年胃溃疡患者心理状态的影响。方法:选取2012年6月—2016年6月于我院住院治疗的中老年胃溃疡且合并幽门螺杆菌感染共120例(观察组),选取体检健康患者共100例作为对照(对照组),使用症状自评量表(SCL-90)评价两组及观察组患者根治幽门螺杆菌感染后的心理状态评分,并进行数据比较分析。结果:观察组患者的总均分(t=5.896,P0.001)、躯体化(t=3.260,P=0.001)、强迫症状(t=3.431,P=0.001)、人际关系敏感(t=5.911,P0.001)、抑郁(t=6.282,P0.001)、焦虑(t=5.366,P0.001)、恐怖(t=5.366,P0.001)和偏执(t=2.274,P=0.024)均显著高于对照,差异均具有统计学意义。治疗后4周,观察组患者的总均分(t=4.272,P0.001)、躯体化(t=4.116,P0.001)、强迫症状(t=4.482,P0.001)、人际关系敏感(t=4.592,P0.001)、抑郁(t=6.859,P0.001)、焦虑(t=5.254,P0.001)、恐怖(t=6.800,P0.001)显著低于治疗前,差异均具有统计学意义。结论:幽门螺杆菌感染可以导致中老年胃溃疡患者产生多种负面心理,根治幽门螺杆菌感染可显著改善患者的负面心理状态。     

cag Pathogenicity island-dependent upregulation of matrix metalloproteinase-7 in infected patients with Helicobacter pylori

Helicobacter pylori (H. pylori) infection has been involved in the pathogenesis of most important gastroduodenal diseases. Matrix metalloproteinases (MMPs) are a large family of zincendopeptidases which play important roles in degradation of extracellular matrix (ECM) and various inflammatory diseases. Therefore, we examined MMP-7 mRNA levels in the gastric mucosa of patients with H. pylori infection and evaluated the effects of virulence factors, such as vacA (vacuolating cytotoxin A) and cagA (cytotoxin-associated gene), in H. pylori-infected patients upon the MMP-7 mRNA mucosal levels. We also determined the correlation between mucosal MMP-7 mRNA levels and the types of disease. Total RNA was extracted from gastric biopsies of 50 H. pylori-infected patients and 50 uninfected individuals. Mucosal MMP-7 mRNA expression level in H. pylori-infected and non-infected gastric biopsies was determined by real-time polymerase chain reaction (PCR). The presences of cagA and vacA virulence factors was evaluated using PCR. MMP-7 expression was significantly higher in biopsies of patients infected with H .pylori compared to uninfected individuals. In addition, mucosal MMP-7 mRNA expression in H. pylori-infected patients significantly associated with the cagA status and the types of disease. Our results suggest that MMP-7 might be involved in the pathogenesis of H. pylori. Peptic ulcer was associated with cag pathogenicity island-dependent MMP-7 upregulation.     

Modes of adherence of Helicobacter pylori to gastric surface epithelium in gastroduodenal disease: a possible sequence of events leading to internalisation

We have investigated various modes of adherence of Helicobacter pylori to the human gastric epithelium, using transmission electron microscopy, in biopsies from nine patients with peptic ulcer disease and from four patients with chronic active gastritis. H. pylori was demonstrated in abundance in all cases within the surface mucous layer. In all ulcer- and in one out of four gastritis patients H. pylori was shown in close proximity to the gastric epithelium, with concurrent alterations in the configuration of microvilli and the apical cytoplasmic region of gastric cells. Previously described modes of H. pylori adherence were confirmed, such as loose attachment with fibrillar-like strands, firm attachment with pedestal formation, invasion in the intercellular spaces, and invagination with "cup" formation. Moreover, in many cases a fusion between the bacterial outer layer and gastric cell membranes was evident. In four cases (31%; three with active and one with past ulcer disease) viable H. pylori was found in the cytoplasm of gastric mucous cells. Our results support the hypothesis that the different modes of adherence of H. pylori represent a stepwise, possibly sequential, process which in a significant number of cases leads to internalisation of the organism. The invariable occurrence of adhesion and more frequent internalisation of H. pylori in ulcer patients may suggest a link with the pathogenesis of peptic ulcer disease.     

Impact of Helicobacter pylori Infection on the Humoral Immune Response to MUC1 Peptide in Patients with Chronic Gastric Diseases and Gastric Cancer

Many investigators have demonstrated alteration of gastric mucins in H. pylori infected individuals. The inflammatory environment induced by H. pylori leading to aberrant glycosylation of MUC1 and demasking of core peptide MUC1 epitope could enhance immune responses to MUC1. IgG and IgM immune response to MUC1 in patients with gastric cancer (n = 214) chronic gastroduodenal diseases (n = 160) and healthy blood donors (n = 91) was studied with ELISA using bovine serum albumin-MUC1 60-mer peptide as antigen. H. pylori serologic status was evaluated with ELISA and CagA status by immunoblotting. Gastric mucosa histology was scored according to the Sydney system. Compared to H. pylori seronegative individuals, higher levels of IgG antibody to MUC1 were found in H. pylori seropositive patients with benign gastric diseases (p < 0.01) and blood donors (p < 0.03). Higher MUC1 IgG antibody levels were associated with a higher degree of gastric corpus mucosa inflammation in patients with chronic gastroduodenal diseases (p < 0.0025). There was a positive correlation between the levels of anti-H. pylori IgG and MUC1 IgG antibody levels in blood donors (p = 0.03), and in patients with benign diseases (p < 0.0001). In patients with gastric cancer (n = 214) a significantly higher level of anti-MUC1 IgG than in blood donors was observed (p < 0.001) irrespective of H. pylori status or stage of cancer. MUC1 IgM antibody levels were not related to the H. pylori serology. IgG immune response to tumor-associated MUC1 is up regulated in H. pylori infected individuals. This increase is associated with a higher IgG immune response to H. pylori and with a higher degree of gastric mucosa inflammation. High levels of MUC1 IgG antibody irrespective of H. pylori serologic status characterized patients with gastric cancer. The findings suggest that, in some individuals, the H. pylori infection may stimulate immune response to tumor-associated MUC1 peptide antigen thus modulating tumor immunity.     

消化性溃疡患儿血浆TGF-α含量的动态观察

目的：了解TGF－α与小儿消化溃疡发生、愈后之间的关系,探讨小儿溃疡可能的发生机制。方法：用放免法测定了57例溃疡患儿的血浆TGF－α的含量。结果：消化性溃疡患儿在溃疡活动期时血浆TGF－α含量明显低于正常对照组（P＜0．01）,在愈合期血浆TGF－α含量基本恢复到正常水平（P＞0．05）。结论：消化性溃疡患儿存在TGF－α分泌异常,血浆TGF－α含量的变化可能与消化性溃疡的发生和愈合有着一定的关系。     

Distribution of vacA alleles and cagA status of Helicobacter pylori in peptic ulcer disease and non-ulcer dyspepsia

The occurrence of cagA and vacA alleles among Helicobacter pylori isolates from Turkish patients and their relationship with ulcer disease outcome was investigated. Among isolates from 47 patients with peptic ulcer disease and 51 patients with non-ulcer dyspepsia, 72.3% and 44.4%, respectively, were cagA-positive (p 0.019). Most (88.8%) isolates were typed as vacA s1, and all of these were subtype s1a. The commonest (51.0%) vacA genotype was s1a m1. The results of multivariate analysis indicated that infection with cagA-positive H. pylori was the only variable associated with an increased risk of peptic ulcer disease (odds ratio, 3.01; 95% confidence interval, 1.27-7.10; p 0.012).