胃息肉与幽门螺杆菌感染相关性研究

The correlation analysis between helicobacter pylori infection and gastric polypus

目的研究胃息肉与幽门螺杆菌（Hp）感染的相关性。方法选取胃息肉患者150例作为观察组,另外,选取慢性胃炎患者150例作为对照组;观察组每例息肉均作做检,记录病理类型,并取周围黏膜即胃窦大、小弯,前、后壁4个部位（距幽门约2~5cm处）做病理检查,观察黏膜炎症程度,并将息肉组织及周围黏膜组织分别作切片经改良吉姆萨（Giemsa）染色法镜检找Hp,观察息肉部位与周围黏膜Hp感染情况;对照组分别在胃窦大、小弯,前、后壁4个部位各取一块组织活检找Hp,并作病理,观察慢性胃炎患者Hp感染率。结果观察组150例,Hp感染率58.0%（87/150）,感染强度以中低强度为主,其中息肉部位HP感染率39.3%（59/150）,非息肉部位HP感染率42.0%（63/150）。增生性息肉102例（68.0%）,Hp感染率63.7%（65/102）;胃底腺息肉31例（20.7%）,Hp感染率38.7%（12/31）;炎性息肉14例（9.3%）,Hp感染率57.1%（8/14）;腺瘤性息肉3例（2.0%）,Hp感染率66.7%（2/3）。单发息肉93例（62.0%）,多发息肉57例（38.0%）,息肉以胃底体多见,其中增生性息肉在胃底体发生率94.1%（96/102）,胃底腺息肉在胃底体发生率87.1%（27/31）,增生性息肉Hp感染率显著高于胃底腺息肉（P〈0.05）,且以中高强度Hp感染为主,增生性息肉胃黏膜炎症活动性发生率较高,同时伴有黏膜肠化、萎缩。慢性胃炎对照组150例,Hp感染率52.0%（78/150）,结果显示胃息肉发生与Hp感染之间无明显相关性。结论胃息肉发生与Hp感染无显著相关性;但胃息肉类型与Hp感染率和感染强度相关,其中增生性息肉Hp感染率和感染强度均显著高于胃底腺息肉。

Objective To investigate the correlation between gastric polyps and helicobacter pylori（Hp）infection.Methods 150 patients with gastric polyps（experimental group）and 150patients with chronic gastritis（control group）from October 2011to November 2012in Shapingba people′s hospital of Chongqing were enrolled in this study.The polyps biopsy in patients with gastric polyps and the mucosa in gastric antrum big and small bends,and the anterior and posterior walls（about 2-5cm from the pylorus） from both groups were detected for the pathological type,inflammation degree and stained（modified Giemsa staining）for detection of the existence of Hp.Results In 150patients with gastric polyps,58%（87/150）of the cases were infected by Hp mainly in medium and low degree,in which 39.3%（59/150）of the infection located at polyps and 42%（63/150）of the infection occurred out of polyps.Pathological analysis for this group further demonstrated that the types of hyperplastic polyps,fundic gland polyps,inflammatory polyp and adenomatous polyps accounted for 68.0%（102cases）,20.7%（31cases）,9.3%（14cases）and 2.0%（3cases）of total 150gastric polyps cases,of which 63.7%（65/102）,38.7%（12/31）,57.1%（8/14）and 66.7%（2/3）cases were infected by Hp,respectively.Pathological analysis also indicated that,among total 150gastric polyps cases,single polyps and multiple polyps types accounted for 62.0%（93cases）and 38.0%（57cases）.The polyps commonly existed at gastric fundus in which the incidence rate of the hyperplastic polyps type and the fundic gland polyps type were 94.1%（96/102）and 87.1%（27/31）,respectively.The infection rate in hyperplastic polyps was markedly higher than that in fundic gland polyps（P0.05）,and the infection of hyperplastic polyps was mainly medium and high degrees.In addition,the inflammatory response in the hyperplastic polyps was higher,accompanied by the intestinal metaplasia and atrophy of gastric mucosa,as compared with non-hyperplastic polyps.In the total 150 control cases,52.0%（78/150）patients were infected by Hp with mainly medium and high degree.Results indicated that there is no relationship between polyps occurring and Hp infection.Conclusion Compared to the chronic gastritis,there is no positive association between gastric polyps and Hp infection.There is no remarkable difference for Hp infection rate and degree between the polyps and the non-polyps sites in the stomach.The infection rate and infection degree of hyperplastic polyps is significantly higher than that of fundic polyps.However,the underlying mechanisms for the development of hyperplastic polyps have to be elucidated in the future.