根除Hp前后胃粘膜多胺含量变化的意义

Alterations of mucosal histology and polyamine contents after Hp eradication

目的探讨成功根除幽门螺杆菌（Ｈｐ）感染后，胃粘膜组织学及多胺（腐胺、精脒和精胺）含量变化的意义．方法Ｈｐ阳性患者５６例，其中男３９例，女１７例；胃溃疡７例，十二指肠溃疡１８例，慢性胃炎３１例．根除Ｈｐ前和根除治疗４ｗｋ～６ｗｋ后胃粘膜多胺含量及其组织学变化，同时设Ｈｐ阴性患者２０例作对照．结果Ｈｐ阳性患者胃窦粘膜蛋白多胺含量（μｍｏｌ／ｇ）明显高于阴性患者（腐胺０９６±０４９ｖｓ０４１±０３１，精脒２０１±０４８ｖｓ０８３±０３７，精胺２５８±０５７ｖｓ１３３±０４２，Ｐ＜００１）．Ｈｐ根除后就显著下降（腐胺０４８±０４０ｖｓ０９４±０４２，精脒１１１±０３４ｖｓ１９８±０３９，精胺１５３±０５５ｖｓ２６６±０４４，Ｐ＜００５）．胃窦部粘膜腐胺和精脒含量高于胃体部（腐胺０９９±０３１ｖｓ０５９±０２４，精脒２０７±０３８ｖｓ１３０±０３４，Ｐ＜００５）．组织学检查显示根除Ｈｐ感染后炎细胞浸润程度明显降低．结论根除Ｈｐ感染能够降低胃粘膜的增殖活性，从而降低胃癌的危险性．

IM To determine whether gastric mucosal histology and polyamine (including putrescine, spermidine, spermine) contents are changed after successful eradication of Hp.METHODS Gastric antral and body biopsies were obtained from 56 Hppositive patients at endoscopy for polyamine contents and histology before and 4-6 weeks after successful triple therapy, and 20 Hpnegative subjects served as controls.RESULTS The polyamine concents in gastric antral protein (μmol/g) in Hppositive patients were higher than those in Hpnegative patients (putrescine 096±049 vs 041±031, spermidine 201±048 vs 083±037, spermine 258±057 vs 133±042,P<005). Mean polyamine contents were significantly decreased after eradication of Hp (putrescine 048±040 vs 094±042, spermidine 111±034  vs 198±039, spermine 153±055 vs 266±044, P<005). The contents of putrescine and spermidine were higher in antral mucosa than in the body (putrescine 099±031 vs 059±024, spermidine 207±038 vs 130±034,P<005). Histologi, cally there was significant reduction in polymorphonuclear leukocyte infiltration in the mucosa.CONCLUSION By decreasing mucosal proliferative activity, Hp eradication may help lower subsequent risk in gastric cancer.