十二指肠炎症、溃疡发生机理探讨

On Pathogenesis of Duodenitis and Duodenal Ulcer

对７４例十二指肠溃疡、６０例胃小弯溃疡、９８例胃窦癌之大部切除胃标本的十二指肠球部组织，检验了它们的胃上皮化生，ＰＡＳ阳性杯状细胞（不完全小肠型肠腺）和幽门弯曲菌（ＣＰ）。结果说明，十二指肠的胃上皮化生与胃部病变性质关系不大；由幽门与十二指肠球部之间可能存在移行区，两者的炎症和溃疡之发生机理也应相似；至于ＣＰ，其存在则对十二指肠炎症（溃疡）的出现起着一定的促进作用。

In order to investigateon the pathogenesis of duodenitis and duodenal ulcer,the authors made observations on gastric metaplasiaPAS-positive goblet cells and Camppy lobacter pylori(CP)in duodenal bul-bus(DuB)of(1)74 cases of(duodenal uleer,(2)60 cases of gastric ulcer &(3)98 cases of gastric carcinoma by means of Alcian blue-pAS staining and Warthin-Stary argentation of the DuB sections.The findings were:Gastric metaplasia seen in(1)(2)&(3)were 51.35%(38/74),46.67%(28/60),&40.82%(40/98),respectively (X2=1.624, P>0.05). PAS-positive goblet cells were found in 68.92%(51/74) of duodenal ulcer,83.10%(118/142) of duodenitis and only 43.75%(7/16)of normal duodenum(X2= 15.544.P<0.05).In cases of duodenal ulcer,non-ulcer,active duodenitis, and inactive duode-nitis, CP were revealed in 41-89%(31/34),11.39%(18/158),33.33%(46/138)and 3.85%(3/78),respectively(P<0.001); no CP was found in normal duodenum.These findings suggest that,no significant relation exisrs between the gastric metaplasia in duodenum and the lesions in the sto-mach; there may be a transitional region between the pyloric canaland duodenum, histological & bioche-micaly features in DuB are similarto those of gastric antrum and soought to be the pathogenesis of duo-denal inflammation & ulcer; and,presence of CP plays a more or lesspromotive role in the development ofduodenitis & duodenal ulcer.