应用定标活检评价根除幽门螺杆菌联合替普瑞酮和叶酸治疗萎缩性胃炎病理组织学的疗效

Evaluation of the Histopathology Effect on Chronic Atrophic Gastritis after Helicobacter pylori Eradication Combined with Teprenone and Tolic Acid by Marking Targeting Biopsy

目的应用定标活检技术评价幽门螺杆菌(Hp)相关性萎缩性胃炎(CAG)根除Hp并联合应用替普瑞酮和叶酸治疗后的病理组织学疗效。方法 225例CAG伴Hp感染患者,根除Hp治疗10天后,再随机分为试验组A组(115例,口服替普瑞酮和叶酸治疗),对照组B组(110例,非特异治疗),疗程6个月,治疗前、后均行胃镜检查,并在胃窦或胃角处定标活检,记录并比较同一部位病理组织学的变化情况。结果治疗前后两组病例胃黏膜病理组织学的变化为黏膜慢性炎症和活动性积分明显降低(P均<0.05),胃黏膜萎缩和肠化积分略有降低(P均>0.05),在胃黏膜病理组织学有效率A组与B组比较,差异有统计学意义(P<0.05)。结论定标活检技术可应用于胃黏膜癌前病变的随访监测,CAG根除Hp并联合应用替普瑞酮和叶酸治疗可使患者胃黏膜病理组织学改善。

Objective To evaluate the histologic therapeutic effect of Helicobacter pylori （Hp） eradication combined with teprenone and folie acid on the chronic atrophic gastritis patients by marking targeting biopsy. Methods A total of 225 chronic atrophic gastritis patients with Hp infection received the eradication therapy for ten days, then all patients were divided into group A （ n = 115 ,treated with teprenone and folie acid） and group B （n = 110, unspecific treatment） , the treatment course lasted for 6 months. Endoscopic biopsy samples were taken from gastric antrum or angle by the technique of marking targeting biopsy to histopathology analysis. The histopathology of the biopsy specimens from the same site obtained at the first and final visit were compared. Results The gastric mucosal histopathology score of monoclear cell infiltration and neutrophil activity markedly reduced after Hp eradication （P 〈 0.05, respectively） , but there was no significant difference statistically in intestinal metaplasia and glandular atrophy score （P 〉 O. 05, respectively）. For the efficacy rate of gastric mucosa pathological improvement,group A comparing with group B,the differences were significant （P all 〈 0.05）. Conclusion The technique of marking targeting biopsy can be used in monitoring for gastric mucosal precancerous lesions to ensure comparability of histological diagnosis. Hp eradication combined with teprenone and tofic acid is essential on the chronic atrophic gastritis correlated with Hp. It may be helpful in reversing gastric mucosal histopathology.