幽门螺杆菌感染与儿童及成人胃炎的病理比较分析

目的　比较儿童与成人胃炎的组织病理学特点 ,进一步阐述幽门螺杆菌 (Hp)感染与胃炎的关系。方法　对 1998～ 2 0 0 0年我院 5 0 0例 3～ 15岁儿童及 4 6 2例成人的胃镜活检组织 ,按Sydney胃炎标准进行组织学和Hp观察。 结果　 4 0 .4 %的儿童胃炎、5 0 .9%的成人胃炎与Hp感染有关。Hp阳性的儿童胃炎与Hp阳性的成人胃炎相似 ,幽门腺萎缩、炎症活动性、淋巴滤泡和嗜酸细胞均较Hp阴性胃炎常见。但儿童胃炎很少发生小肠化生 ,这与成人胃炎不同。结论　与成人胃炎一样 ,儿童胃炎活动性与Hp感染关系密切。Hp阳性儿童胃炎的胃黏膜病理变化较非感染者严重 ,常表现为淋巴滤泡形成及中性白细胞浸润。本研究还证实 ,上海属于儿童Hp感染的高发区 ,且儿童胃炎Hp阳性病例的胃黏膜与成人胃炎接近。为减少胃癌及胃溃疡的发生 ,对Hp感染的防治应从儿童抓起

Helicobacter pylori infection and gastritis: a comparison of histopathology of gastritis in children and adults

Objective To compare the histopathology of gastritis in children and adults, and to elucidate the relevance of helicobacter pylori (H. pylori) infection and gastritis. Methods Materials of consecutive gastroscopic biopsies from 1998 to 2000 in Ruijin Hospital, Shanghai were evaluated in 500 children (from 3 to 15 years old) and 462 adults for the existence of H. pylori whether or not associated with gastritis using Sydney System for the classification. Results 40.4% children and 50.9% adults gastritis were found to be associated with H. pylori infection. As compared with those absence of H. pylori infection, the gastritis of the children and adults induced more frequent occurrence of antral atrophy, more severe active inflammation with more often presence of lymphoid follicles and eosinophils. Intestinal metaplasia, however, was rarely found in gastritis of children with H. pylori infection. Conclusion Both children and adults gastritis with H. pylori infection represent more severe pathologic changes than those without H. pylori infection. Therefore it is important to treat them in early childhood especially for the prevention of cancer.