幽门螺杆菌感染与慢性萎缩性胃炎的相关性

Study on relativity between helicobacter pylori infection and chronic atrophic gastritis

目的探讨幽门螺杆菌感染与慢性萎缩性胃炎胃腺体萎缩、肠化、不典型增生及癌变的相关性。方法456例患者均经胃镜及病理检查诊断慢性萎缩性胃炎;Hp感染采用13/14C尿素呼气试验,病理组织学Giemsa染色法找寻Hp呈阳性。患者分为两组:Hp阳性组112例,Hp阴性组195例。分别观察胃腺体萎缩、肠化、不典型增生及癌变率。结果456例患者中,Hp阳性者222例,阳性率48.68%。其中萎缩:轻度214例(49.77%);中重度8例(34.78%)。肠化:轻度131例(45.64%);中重度7例(29.17%)。异型增生:轻度46例(43.40%);中重度3例(23.08%)。癌变:6例(1.32%)。Hp阳性组和Hp阴性组胃腺体萎缩、肠化、异型增生程度及癌变的差异行χ2检验,结果显示:萎缩(χ2=1.992,P=0.158);肠化(χ2=2.436,P=0.119);异型增生(χ2=1.974,P=0.160),差异无显著性。结论幽门螺杆菌感染不是慢性萎缩性胃炎的唯一病因,应关注其他因素。

[ Objective ] To find the relativity between the H.pylori infectionand and the chronic atrophic gastritis. [Methods] The 456 patients were diagnosed by gastroscopy and pathologica study as CAG（ accompanied with intestinal metaplasia, dysplasia or canceration）. Hp irdection was found basing on a positive test for 13/14C-UBT and pathologica study. [Results] Among the 222（48.68% ） H.pylori positive of the total 456 subjects who were diagnosed of CAG ,the atrophic： mild 214 （49.77%）, moderate / severe 8 （34.78%）, intesfnal metaplasia： mild 131 （45.64%）; m/s 7 （29.17%）, dysplasia： mild 46（43.40%）; m/s 3（23.08%）. Canceration： 6（1.32%）. There was no significant statistically difference between H.pylori positive patients and H.pylori negative patients in atrophic, intesfnal metaplasia, and dysplasia. The X^2 test included atrophic（X^2=1.992, P =0.158）; intesfnal metaplasia（X^2=2.436,P = 0.119）; dysplasia （X^2=1.974,P =0.160）. [Conclusion] The H.pylori infectionand is not the only cause of he chronic atrophic gastritis.