老年人胃黏膜病理学改变特点与幽门螺杆菌感染的相关性分析

Correlation between Helicobacter pylori infection and pathological characteristics of gastric mucosal in the elderly

目的 探讨幽门螺杆菌（Hp）感染与老年患者胃黏膜组织病理改变特点,以提高临床医师对Hp感染后的胃黏膜组织病理变化特点的认识.方法 回顾性分析2014年1-6月于我院接受胃镜及碳13呼气试验检查的良性上消化道疾病患者278例,依据年龄分为年龄≥60岁老年组111例和年龄＜ 60岁非老年组167例,分别观察两组患者Hp感染情况及胃黏膜组织病理变化（慢性重度炎症、中性粒细胞浸润、淋巴滤泡、腺体萎缩、肠上皮化生）与Hp感染的关系.结果 老年组与非老年组比较,Hp感染率为分别为27.0％（30/111）和36.5％（61/167）,差异无统计学意义;腺体萎缩分别13.5％（15/111）和6.0％（10/167）,差异有统计学意义（P=0.028）;Hp感染者重度慢性炎症、中性粒细胞浸润、淋巴滤泡形成、腺体萎缩和肠上皮化生分别为73.6％、70.3％、14.3％、18.7％、29.7％,均高于Hp阴性者19.8％、3.2％、0.5％、4.3％、8.6％,差异均有统计学学意义（P=0.000）;排除Hp感染因素,老年组与非老年组腺体萎缩率分别为8.6％和0）.9％（P=0.013）;Hp阳性肠上皮化生率老年组与非老年组分别为43.3％和23.0％（P=0.045）.结论 Hp感染与胃黏膜组织重度慢性炎症、中性粒细胞浸润、淋巴滤泡形成有关;腺体萎缩、肠上皮化生不仅与Hp感染有关,年龄亦是其影响因素.

Objective To investigate the correlation between helicobacter pylori infection and pathological characteristics of gastric mucosal in the elderly.Methods Retrospective analysis was conducted in 278 patients with benign upper gastrointestinal disease from January 2014 to June 2014.The patients were examined by endoscopy and 13C-UBT,and divided into elderly group （aged 60 years and over,n=111） and non-elderly group （aged〈60 years,n=167）.The relationships between Hp infection and pathological changes in gastric mucosal tissue （severe chronic inflammation,neutrophil infiltration,lymph follicles,gastric gland atrophy,intestinal metaplasia） were analyzed.Results There was no significant difference in helicobacter pylori infection rate between the elderly group and non-elderly group [27.0% （30/111） vs.36.5% （61/167）,P〉0.05].The rate of gastric gland atrophy was higher in elderly group than in non-elderly group [13.5% （15/111） vs.6.0% （10/167）,P=0.028].The rates of severe chronic inflammation,neutrophil infiltration,lymph follicles,gland atrophy and intestinal metaplasia were 73.6%,70.3%,14.3%,18.7%,29.7% in patients with helicobacter pylori infection,which were higher than those in patients without helicobacter pylori infection （19.8%,3.2%,0.5%,4.3%,8.6%,respectively,all P=0.000）.Removing the factor of Hp infection,the rates of glands atrophy and intestinal metaplasia were higher in elderly group than in non-elderly group （8.6% vs.0.9%,43.3% vs.23.0%,P=0.013 and 0.045）.Conclusions Helicobacter pylori infection correlates with severe chronic gastric mucosal inflammation,neutrophil infiltration,lymph follicles formation.Gland atrophy and intestinal metaplasia are related to the Hp infection,and age is also their influencing factor.