胃幽门螺杆菌感染与所致淋巴组织病变的相关性及其治疗评价

The relationship between Hp infection and its induced lymphoid tissue pathological changes and the treatment evaluation

目的探讨胃幽门螺杆菌(Hp)感染与所致各级胃淋巴增殖症(GLH)病变的相关性及其有关影响因素,对各级患者的治疗结果进行对照评价.方法对Hp感染而有淋巴细胞性胃炎(LCG)和GLH病变的患者(n=77),根据胃镜和组织学病理表现参照Isaacson组织学评分标准分为4组/级,所有患者均采用根除Hp方案治疗,治疗后2个月复查胃镜及黏膜活检标本,观察Hp与LCG、GLH、萎缩、肠化等病变之间的消涨关系.结果所有患者组织学病理均不同程度减轻或消失,Ⅰ～Ⅱ级病变疗效明显优于Ⅲ～Ⅳ级(P<0.05),Hp与LCG和GLH之间存在明确的消涨关系,抗Hp治疗可逆转病变.结论抗Hp治疗对LCG和GLH病变有积极作用,影响疗效的因素包括病程、淋巴细胞生发中心、上皮病变及黏膜萎缩和肠化等.

Objective To survey the relationship between Helicobacter pylori （Hp） infection and lymphoid tissue pathological changes, and to evaluate the effect of treatment on different degree of the disease. Methods Seventy-seven cases with Hp infection and pathological changes in the gastric mucosa lymphoid tissue were divided into 4 groups （degrees） according to Isaacson＇ s criteria of gastric lymphoid hyperplasia （GLH）. All of them were treated with eradication of Hp. The endoscopy and pathological examination of gastric mucosa were performed before and after treatment. Result After two months of the treatment ,the lymphocytic gastritis （LCG） and GLH have vanished and lightened in different degree. The effect on degree Ⅰ-Ⅱ of GLH was better than that on degree Ⅲ-Ⅳ（ P 〈 0.05 ）. Conclusion The eradication of Hp has a positive role to the GLH focus,the affecting curative factors include the course of disease ,the hyperplasia degree of lymphocyte growth center, the lymphoepithelial lesion ,the atrophy of mucosa and gland as well as intestinal metaplasia.