幽门螺杆菌感染与不同胃炎及病理之间的关系

Relationship between Helicobacter pylori infection and different gastritis and pathology

目的分析幽门螺杆菌(Hp)感染与不同胃炎及病理改变之间的关系,探讨Hp在胃炎进展中的作用。方法选择2013年1月-2015年6月行胃镜及病理检查证实的胃炎患者1 238例,且所有患者均接受Hp检测,观察Hp感染与不同类型胃炎、病理不同炎症反应程度及癌前病变的相关性。结果萎缩性、糜烂性及浅表性胃炎患者Hp检测阳性率分别为80.73%、74.16%、51.94%,DPM值分别为436.41±239.58、317.39±224.97、125.38±89.24,组间比较差异有统计学意义(P<0.05);重度、中度、轻度炎症反应患者Hp感染阳性率分别为87.13%、73.14%、53.76%,DPM值分别为458.16±232.45、365.82±232.18、113.46±88.76,组间比较差异有统计学意义(P<0.05);有肠上皮化生、上皮类瘤变患者Hp感染阳性率分别为94.25%、94.51%,DPM值分别为465.36±222.76、389.25±172.39,无肠上皮化生、无上皮类瘤变患者分别为61.34%、61.20%,252.19±132.45、269.27±158.3),比较差异有统计学意义(P<0.05)。结论 Hp与胃炎的严重程度有关,可加重炎症反应,促进慢性胃炎肠上皮化生及上皮类瘤变。

OBJECTIVE To investigate relationship between Helicobacter pylori（Hp）infection and different types of gastritis and pathological changes and explore the role of Hp in progress of gastritis.METHODS A total of 1 238 cases of gastritis patients with the pathological examination were selected from Jan.2013 to Jun.2015 and all the patients were detected with Hp.The correlation of Hp infection with different types of gastritis,pathological changes of inflammatory reaction and precancerous lesions were observed.RESULTS Hp positive rate in the atrophic gastritis,erosive gastritis and superficial gastritis were 80.73%,74.16% and 51.94%respectively;DPM scores were respectively 436.41±239.58,317.39±224.97 and 125.38±89.24,and the differences between the groups were significant（P〈0.05）.Hp positive rate in severe,moderate and mild inflammation patients were87.13%,73.14% and 53.76% respectively;DPM scores were 458.16±232.45,365.82±232.18 and 113.46±88.76,and the differences between the groups were significant（P〈0.05）.Hp positive rate in patients with intestinal metaplasia and epithelial neoplasia were respectively 94.25% and 94.51%;DPM scores were respectively465.36±222.76 and 389.25±172.39,while in the non-intestinal metaplasia and epithelial neoplasia patients,the results were 61.34% and 61.20%,252.19±132.45 and 269.27±158.36,and the differences were significant（P〈0.05）.CONCLUSION Hp is related to the severity of gastritis,which can aggravate the inflammatory reaction and promote the growth of intestinal metaplasia and epithelial tumor of chronic gastritis.