消化系统病变黏膜中不同形态幽门螺杆菌的分布特点及临床意义

Mucosal lesions in digestive system of different forms of helicobacter pylori distribution characteristics and clinical significance

目的探讨消化系统病变黏膜中不同形态幽门螺杆菌的分布特点及其临床意义。方法选取我院行胃镜检查的门诊或住院患者共540例,对其行胃镜检查,观察黏膜形态,分别钳取胃角、胃体、胃窦及十二指肠部位的少量黏膜组织,并行HE染色、银染色及免疫组织化学染色。结果患者HP感染率为45.9%(248/540),银染法及免疫组化方法检出HP的阳性率分别为46.3%、46.9%。螺杆状HP在胃角、胃体及胃窦黏膜分布尚不能认为存在,差异无统计学意义(P>0.05);而其在十二指肠中(34.0%)的分布显著低于胃部黏膜(胃角92.5%、胃体90.9%、胃窦87.4%),差异有统计学意义(P<0.05)。在65例单纯球形HP感染患者中,胃角、胃体检出率均低于胃窦,差异有统计学意义(P<0.05)。结论螺杆状HP主要分布于胃部,多伴随有十二指肠球部感染;而球形HP感染多分布于胃窦,可能与胃窦部泌酸能力较强从而使螺杆状HP受到环境刺激有关。

Objective To investigate the distribution characteristics and clinical significance of the different forms of H. pylori in digestive mucosa lesions. Methods During in our hospital a total of 540 cases of hospitalized or outpatients service patients were chose to undergo endoscopy examinations. Mucosal morphology of the patients were observed and angle stomach were removed by the pliers, gastric body, stomach sinus respectively and a small amount of duodenal mucosa parts for HE staining, silver staining and immunohistochemical staining. Results Patients in the study HP infection rate was 45.9% （248/540）, silver staining and immunohistochemistry positive rate of HP was 46.4% , 46. 9% respectively. HP screw- shaped angle in the stomach, gastric antral mucosa and distribution still can not believe that there was significant difference （P 〉 0. 05）, and its distribution in the duodenum （33.8%） was significantly lower than the stomach mucosa （ stomach angle 92.4%, 90. 9% gastric body, antrum 87. 4% compared obtain all P 〈0. 05）. 65 cases of simple spheri- cal HP - infected patients, the gastric angle of the stomach antrum were lower than the physical examination （P 〈 0. 01 ）. Conclusion The screw- like HP are mainly distributed in the stomach, accompanied by multi -duodenal infections; spherical HP infection distributed in the gastric antrum, gastric antrum may be acid secretion ability so that the screw - like HP by environmental stimuli related.