幽门螺杆菌感染的理想检测部位

以Warthin－Starry染色检测幽门螺杆菌（HP），HE染色观察胃炎程度，观察了90例HP阳性患者在胃底、胃体、角切迹、幽门前区大弯的分布情况和177例患者的胃糜烂部位与非糜烂部位的HP感染状况，发现：HP感染至全胃分布，各部位HP阳性率无明显差异（P＞0．05），但HP数量和胃炎程度有差异且二者有明显相关性（r=0．948），以角切迹HP数量最多、胃炎程度最重、局灶萎缩性胃炎和活动性胃炎的发生率亦最高；胃窦、胃体、胃底的HP数量、胃炎程度则依次降低。非糜烂部位的HP检出率为62．7％，糜烂部位的HP检出率为58．8％，二者无明显差异（P＞0．05），四型糜烂间HP检出率无显著性差异（P＞0．05）。结果提示：胃角切迹是检测HP感染、观察胃炎程度的理想部位，从糜烂部位取活检不一定能提高HP检出率。

TIIE OPTIMAL GASTRIC SIGHT FOR DETECTING HELICOBACTER PYLORI INFECTION

Gastric biopsies were taken from the fundus, the lesser curve in the mid-corpus, gastric angle, and the prepyloric great curve antrum in 90 patients with H. pylori infection. Gastric biopsies were also taken from the erosive andnon-erosive sites of 177 patients with gastric erosions. Warthin-Starry staining was used to detect H. pylori, andHematoxylin and Eosin were used to observe the severity of gastritis. The fundic site was mpitive for H. pylori in92. 2 % of the subjects, the corpus site in 93. 3 %, the gastric angle site in 91. 1 %, and the prepyloric site in 92. 2 %,with on significant difference between the H. pylori infection rates (P >0. 05). H. pylori was found to be unevenlydistributed throughout the whole stomach, with the highest mean density score for H. pylori and the highest meangrade of gastritis found in the gastric angle site. The mean density scores for H. pylori and the mean grade scores forgastritis were lower in the antrum, corpus and fundus. The changes in the intragastric distribution of H. pylori werewell concordant with the changes in the severity of gastritis (correlation coefficient = 0. 948). The H. pylori detection rates in erosive and non-erosive sites were 58. 8 % and 62. 7%, respectively, with no significant difference (P >0. 05). No significant differences were found between the H. pylori infection rates in each of the four subtypes ofgastric erosion (P >0. 05 ). The results suggest that the best gastric site for the detection of H. pylori infection is thegastric angle.