广东潮阳地区海尔曼螺杆菌感染与食管疾病的相关性研究

Relationship between Helicobacter heilmannii infection and esophageal diseases in Chaoyang, Guangdong Province, China

目的:探讨广东省潮阳地区海尔曼螺杆菌(Helicobacter Heilmannii,Hh)感染与食管疾患的关系. 方法:集我院内镜活检标本和连有部分食管的胃切除标本, 共92例.以Warthin—Starry银染色,镜检Hh和幽门螺杆菌(Helicobacter Pylori,Hp).结果与临床和病理结果对比分析. 结果:92例共检出Hh(+)者43例,占46.74%,Hp(+)者32例,占37.78%,二者混合感染者12例,占13.04%. 43例Hh(+)者中:食管癌19/33例(占本组的20.65%,占该疾病的57.58%,下同),食管贲门腺癌14/22例(15.22%, 63.64%),食管溃疡3/11例(3.26%,27.27%),食管上皮增生4/8例(4.35%,50.0%),食管炎1/3例(1.09%,33.33%), 食管平滑肌瘤1/2例(1.09%,50.0%),Barrett食管1/1 例(1.09%,100%).随访家中养有猪狗猫或其中之一者16 例,Hh(+)者10例(62.5%),未养上述动物者23例,其中Hh(+)者8例(34.78%). 结论:食管Hh感染明显与食管癌、食管贲门腺癌、食管上皮增生等相关,Hh感染可能是潮阳地区上述疾病高发的重要因素之一,感染又可能与该地区普遍养有猪狗猫等动物有关.

AIM: To study the relationship of Helicobacter heilmannii (Hh) infection with esophageal diseases in Chaoyang, Guangdong Province, China. METHODS: A total of 92 cases of endoscopic biopsies and esophagostomies were collected. Hh and Helicobacter pylori(Hp) infection were detected by Warthin-Starry silver stain. RESULTS: Among 92 cases, 43 cases were Hh positive (46.74%), 32 cases were Hp positive (37.78%), and mixed infection with Hh and Hp were detected in 12 cases (13.04%). Among 43 Hh positive cases, there were 19 cases of esophageal carcinoma, 14 esophagocardiac adenocarcinoma, 3 esophageal ulcers, 4 epithelial hyperplasia, 1 esophagitis and 1 Barrett' esophagitis. Following-up data showed that 16 patients had a history of raising dogs, swines or cats, in which Hh infection were found in 10.23 patients denied having a history to contact the animals mentioned above, in which 8 cases were Hh positive. CONCLUSION: Hh infection has a close connection with esophageal carcinoma, cardiac adenocarcinoma and epithelial hyperplasia, and may be a high risk factor for those diseases in the area. The pathogenesis of the disease may be related to domestic animal raising.