胃粘膜幽门螺杆菌感染密度在消化性溃疡诊断和治疗中的意义

作者从1987年开始通过内镜对幽门螺杆菌(Helicobacter pylori简称HP)感染密度与消化性溃疡的关系进行了研究。内镜确诊的消化性溃疡(peptic ulcer,简称pu)766例中,有24.8％的患者胃窦粘膜检出了不同密度的Hp感染,从而支持该菌是消化性溃疡病原的学说。胃窦Hp感染的密度分布,O级25.20％(193/766),Ⅰ级为45.95％(352/766),2级为15.27％(117/766),3级为13.58％(104/766)。作者采用治疗Pu及清除Hp相结合,局部治疗与系统治疗相结合的综合治疗。结果PU治愈率100％,其中Pu治愈伴细菌清除者为88.88％,其中11.12％Pu治愈而Hp仍存在,其Hp感染密度皆为3级。而HP继续存在的病例,PU累积一年复发率为5.74％,在193例无Hp感染的Pu患者中,有5例复发,复发率为2.59％(5/193累积1年复发率)。Hp感染密度分析表明:Hp感染可能是Pu的病原,治Pu与Hp结合,局部治疗与系统疗法相结合,是短程高效及低复发率的根本。

THE VALUE OF HP DENSITY OF GASTRIC MUCOUS MEMBRANE FOR THE DIAGNOSIS AND TREATMENT OF PEPTIC ULCER

Since 1987 year, we have studed the relationship between the helicobacter pylori (HP) density and the peptic ulcer by means of endoscopy. More than ceventy four per cent of 766 patients with peptic ulcer (PU)were found with various degree of HP infection. this result suggests that HP may be the pathogen of the peptic ulcer. The densities of gastric antrum HP were 25. 20%, 45, 95%, 15. 27%, 13. 58%respectively in O degree, 1 degree, 2degrees, and 3 degrees. We combined the management of PU with the overthrowing HP, local treatment with systemic therapy. The curative rate was 100 percent, including 88. 88% cases neither of PU and HP,and 11. 12% PU healing but the HP remained. The infection degree of all the patients with remained HP was 3 degree,the reccurent rate of PU was 5. 74% within one year after treatment, but the reccurent rate of PU in 193 patients without HP was only 0. 026 per cent. Our results showed that the HP infection might be the PU pathogen and the combined management of PU with obliteration of HP as well as the combined local therapy with systemic care were the base of PU treatment.