人胃螺杆菌感染的随访

A follow-up survey of helicobacter heilmannii infection

人胃螺杆菌(Hh)是一种目前尚不能培养的胃内致病菌,国内外对其研究很少。我们从3174例受检者中检出51例 Hh 并进行了不同程度的随访观察。材料与方法:病例来源于回顾性病理检查(2/634,0.32%)、组织学检查(11/654,1.68)、涂片筛检(37/1655,2.24%)和临床涂片检查(1例),采用形态学方法诊断.结果:(1)Hh感染的高峰年龄在19～27岁或以前,呈下降趋势。(2)冬春季检出率最高;(3)症状以上腹部疼痛为主.(4)Hh 混合 Hp 占18.9%;轻度慢性浅表性胃炎占86.5%;1例急性感染,病变较重者多混合 Hp 感染.66.7%自动转阴,经抗菌治疗者86.7%Hh 或 Hp 消失。(5)96.4%有可疑的疫源接触史(狗、猫和猪).本研究结果表明:Hh 感染主要来源于动物,引起轻症胃炎。好发于青年(或儿童),多发于冬、春季,有自愈趋势,抗菌治疗多有效。同时提出,年轻人群中可能在感染 Hh 后,先引起急性胃炎,大部分自然痊愈,少部分发展成轻度慢性浅表性胃炎。

Helicobacter heilmannii(Hh)is an uncultivated pathogen in human stomach,and few studies in the world.Fifty-one cases of Hh were follow-up survey in different degree,which found out from 3174 subjects.METHODS:Cases getting from retrospective pathological examination(2/634, 0.32%),histological examination(11/654,1.68),smear screening(37/1655,2.24%)and clinic smearing (1).Hh diagnosis depends on morphology(Warthin-Starry stain and Gram's stain).Letter for follow-up survey,28 volunteers to re-examine were preceded.RESULTS:(1)In 6 groups of Hh diagnose ages from 19 to 66,Hh in each group respectively is 33.3%,29.4%,13.7%,5.9%,11.8%,5.9%.The highest infection is seam in the 19～27 years or younger and trend to decrease.(2)Hh detective rates in 1 month from January to December are 14.3%,5.2%,1.8%,2.6%,3.4%,1.4%,0.5%,0.5%,1.0%,1.7%,1.6% and 2.2%,and the highest was in winter and spring.(3)Four cases(7.8%)without symptom,47 cases with symptom,mainly pain in upper abdomen in every period,subacute period with distinctly hungry feeling,chronic period with nausea and vomiting.(4)Mixed infection of Hh and Hp in 7 out of 37 cases (18.9%),86.5% subjects with mild superficial gastritis(CSG),except 1 with acute infection,all the severe cases infect mixing with Hp.66.7%(12/18)Hh infection disappear naturally in 5～222 (34.9±55.9)days,86.7%(13/15)were cured with antibacterials.(5)96.4% of the patients have suspensive history of contagium(dogs,cats and pigs),which our previous investigations show that there are Hh-like organisms in 100% dogs,84.6% cats and 15.8% pigs.CONCLUSION:Hh mainly comes from animals,and cause mild gastritis,is predilection younger person in winter and spring.It trends to disappear naturally and treatment in effect with antibacterials.We also suggest that Hh may infect younger persons and cause their acute gastritis by transient infection,a few of cases develop to chronic gastritis.