根除Hp对高原地区Hp相关性慢性胃炎病理变迁和溃疡转归的影响

目的:观察根除幽门螺杆菌(Hp)感染对高原地区Hp相关性慢性胃炎病理变迁和溃疡转归的短期影响。方法:对Hp阳性的37例慢性胃炎和30例溃疡患者均给予以洛赛克为中心加两种抗生素的三联一周疗法,停药一月后复查Hp并观察胃镜和病理组织学变化,与根除Hp治疗前进行对比分析,同时统计Hp根除组和未根除组溃疡的愈合率。结果:37例慢性胃炎中32例Hp被根除,30例溃疡中14例Hp被根除(2例未复查),平均Hp根除率70.77%;Hp根除前慢性胃炎组中有19例胃炎活动,治疗后16例Hp被根除,根除者胃炎活动完全消退,消退率100%,而3例Hp未根除者仅1例胃炎活动完全消退,消退率33.33%(P<0.05);28例溃疡在Hp根除治疗前均有胃炎活动的病理组织学改变,14例Hp根除者中,13例胃炎活动完全消退,消退率92.86%,14例Hp未根除者中,只有6例胃炎活动完全消退,消退率42.86%(P<0.05);所有的慢性胃炎和溃疡患者胃窦粘膜均有不同程度的萎缩、肠化和异型增生,两组Hp根除前后其上述病理组织学变化均无明显改善(P>0.05);Hp根除组溃疡全部愈合,愈合率达100%,未根除组只有8例愈合,愈合率为57.14%,两组比较Hp根除组溃疡愈合率显著高于未根除组(P<0.05)。结论:根除Hp感染可使绝大部分胃炎的活动性消退,并可明显提高溃疡的愈合率,而Hp根除后短时间内无慢性胃炎(萎缩、肠化、异型增生)逆转的病理组织学表现,需长期随访观察。

The Treatment Effects of Eradicated Hp on the Change of Chronic Gastritis and Peptic Ulcer in Plateau

Objective:To observe the short term treatment effect of eradicated Hp on the change of chronic gastritis and peptic ulcer with Helicobacter pylori(Hp) in plateau.Methods: 37 cases with chronic gastritis and 30 cases with peptic ulcer,who were infected with Hp(positive Hp),were treated with losec two kinds of antibiotic for one week,the changes of Hp,endoscopy and pathology were observed after and before treatment.The healing rates of eradicating Hp and non-eradicating Hp were recorded.Results: 46 of 67 cases(32/37,14/30,2 cases escaped) were eradicated,.The average cure rate was 70.77%;the disappearing rate of Hp was 100%.28 cases peptic ulcer showed to have gastritis active change of pathology before treatment;active gastritis in 13 of 14 cases showed completely disappeared after Hp eradicated;the disappearing rate was 92.86%.All patients had some atrophic,intestinal change and untypical proliferate.No notably change of pathology before and after treatment(P>0.05).Hp was eradicated(100%) in the group of peptic ulcer but only 8 cases in other group(57.14%,).Conclusions: Active show of chronic gastritis can be disappeared and the healing rate of gastric ulcer can be increased by eradicated Hp.After HP eradication the short term effects of pathology on chronic gastritis(atrophic,intestinal change and untypical proliferate) is not better.It would be a longtime work.