慢性胃炎病理组织学特征及与幽门螺杆菌的关系

目的研究慢性胃炎的组织病理学特征及幽门螺杆菌(Hp)感染与慢性炎症程度的关系。方法回顾性分析2000年1月~2002年12月经胃镜诊断为慢性胃炎1600例的胃窦黏膜病理组织学检查结果,根据胃镜检查结果进行HE染色,作组织学诊断及W-S银染色行Hp计数。结果1600例中Hp阴性1007例,阳性593例。Hp阴性病例中轻度炎症(86%)明显较中重度炎症(14%)多见;Hp阳性病例中尽管轻度炎症在轻度Hp感染中最常见(63%),而中度以上炎症主要在Hp阳性组,并随Hp菌量增加,中重度炎症明显增多,轻度炎症明显减少。胃窦黏膜中淋巴、中性粒细胞和淋巴滤泡比例Hp阳性组(94%、40%、22%)明显高于Hp阴性组(60%、11%、5%),差异均有显著性。腺体萎缩Hp阳性组(16.5%)高于阴性组(7%);肠腺化生分别为1.5%和0.1%,亦呈Hp阳性组高于Hp阴性组。结论Hp是小儿慢性胃炎重要致病因素,提示Hp与胃窦黏膜慢性炎症程度及黏膜萎缩有密切关系。

Relationship between Characteristic of Pathohistology and Helicobater Pylori in Chronic Gastritis

Objective To further investigate the pathohistology of chronic gastritis in children and the relationship between helicobacter pylori(Hp) infection and mucosal chronic inflammatory.Methods Gastric antrum biopsies were carried out from children who had chronic gastritis confirmed by gastroendoscopy during the past 3 years in our hospital.The results of pathohistological observation were analyzed by retrospectire method.Results One thousand six hundred cases of chronic gastritis were included,in which 1007 cases without Hp infection,593 with Hp infection.Among the patients without Hp infection,mild inflammatory were much more than mode-(rate) or severe inflammatory(86% vs 14%).Although,in patients with Hp infection,mild inflammatory were the most common presentation(63%),moderate and severe inflammatory were more predominant in patients with Hp infection.The degree of inflammatory was increased with the quantity of Hp infection.The ratio of lymphocytes,neutrophils and lymphoid follicles in gastric mucosa was much higher in Hp positive group than negative one(94%,40%,22% vs 60%,11%,5%,respectively),and the difference was significant in statistic analysis.Gastric mucosal atrophy was found more in Hp positive group(16.5%) than negative one(7%).The proportion of intestinal metaplasia in cases with Hp infection was 1.5% compared with 0.1% in these children.Conclusion The study shows that there is a close relationship between Hp and antrun chronic inflammation and mucosal atrophy.