30例Barrett食管内镜下特点及与幽门螺杆菌感染的关系

目的 探讨30 例Barrett 食管（Barrett esophagus， BE） 的内镜下特点及与幽门螺杆菌（Helicobacter pylori， Hp） 感染的关系。方法 采用胃镜检查结合病理检查结果对30 例BE 患者进行分析，同时选取反流性食管炎及正常食管黏膜各50 例作为对照组，采用快速尿素酶法及Warthin-Starry 银染两种方法检测Hp 感染。结果 30 例BE 中，以短段、舌型发病率最高，分别占83.33% 和66.67% ；组织学上，胃底型12 例（40%），贲门型10 例（33.33%），特殊肠化生型8 例（26.67%）。食管部Hp 的检出率，BE 组阳性率明显高于反流性食管炎组和正常食管黏膜组（P ＜ 0.05）。胃窦部Hp 的检出率，BE 组显著低于反流性食管炎组和正常食管黏膜组（P ＜ 0.05）。结论 本组BE 病例内镜下以短段、舌型为主，Hp 对BE 可能有保护作用。

Relation between endoscopic characteristies of Barrett esophagus and Helicobacter pylori infection in 30 patients

Objective To study the relation between endoscopic characteristies of Barrett esophagus（BE） and Helicobacter pylori （Hp） infection in 30 patients. Methods Thirty BE patients who underwent gastric endoscopy and pathological examination served as a BE group, 50 reflux esophagitis （RE） patients served as a RE group, and 50 normal subjects served as a control group. Hp infection was detected by rapid urease test with Warthin-Starry staining. Results The incidence of short segment and tongue BE was 83.33% and 66.67%, respectively in 30 BE patients. Among the 30 BE patients who underwent histological examination, fundic BE was detected in 12 （40%）, cardia BE was found in 10 （33.33%） and intestinal metaplasia BE was revealed in 8 （26.67%）. The positive Hp detection rate was significantly higher in esophagus of BE group than in esophagus of RE group and control group （P 〈 0.05）, and significantly lower in antrum of BE group than in antrum of RE group and control group （P 〈 0.05）. Conclusion Short segment and tongue BE are frequently detected in BE patients. Hp may protect BE.