儿童与成人幽门螺杆菌相关性胃炎病理特征的差异

目的:了解儿童和成人各个年龄段人群感染Hp后的胃粘膜病理变化特点及探索其可能的发病机制。方法:对40例儿童和45例成人Hp相关性胃炎病人的病理变化作回顾性分析。结果:儿童Hp相关性胃炎的病理变化以浅表炎症为主,而在成人年龄越大,萎缩性胃炎的比例越高,两者比较差异显著(x~2=11.93,P<0.005)。成人组胃粘膜炎症中中性粒细胞的比例明显高于儿童组,两者比较差异显著(x~2=31.17,P<0.005)。成人组胃粘膜固有腺体萎缩和肠上皮化生也明显高于儿童组(分别为x~2=11.93,P<0.005,x~2=11.84,P<0.005)。而儿童组淋巴滤泡形成明显高于成人组,两者比较差异显著(x~2=5.89,P<0.025)。结论:各年龄段人群感染Hp后在胃粘膜病理变化上存在着差异,随着年龄增大,急性炎症越明显,胃粘膜萎缩及肠上皮化生的发生率亦越高。提示Hp感染存在某种与年龄相关的宿主方面反应上的差异。

Comparative Study of Pathologic Difference in Pediatric and Adult Patients with Hp-associated Gastritis

Purpose: To study the pathologic changes and mechanism of gasrtic mucus in adult and pediatric patients with age after Hp infection. Methods: Retrospective analysis of 40 children and 45 adults with Hp-associated gastritis was performed. Results: Superficial inflammation was the main pathologic change in pediatric Hp-associated gastritis, atrophic gastritis become more common in adults, there was significant difference between the two groups(x2 = 11.93,P<0.005). The proportion of neutropilic infiltration of gastric mucosa in adult. Hp-associated gastritis was significantly higher than that in children(x2 = 31.11, P <0.005) ,as well as the intestinal metaplasia and glandular atrophy(respectively x2 = 11.93,P< 0.005,x2 = 11.84,P < 0.005). And the formmng of lymphatic follicle in children gastric mucosa was significantly higher than that in adults(x2 = 5.89,P<0.025). Conclusion : Pathologic changes after Hp infection are difference in different patients age groups advancing with more severe acute inflammation, mucosa atrophy and intestinal metaplasia. The result suggest that there were some difference between the Hp infection and the aspect of host age-related respone.