胃黄色瘤及幽门螺杆菌核酸联合分型检测与胃良性疾病严重程度之间的关系

The relation between gastric xanthelasma,nucleic acid testing of Helicobacter pylori and severity of gastric benign diseases

目的研究胃黄色瘤、幽门螺杆菌(Helieobacter pylori,Hp)核酸联合分型检测与胃良性疾病严重程度之间的关系。方法选取2018年1月至2019年3月于首都医科大学附属北京安贞医院消化内镜中心行胃镜检查的患者,其中胃黏膜活检组织Hp核酸检测阳性并诊断为胃黄色瘤的患者159例,包括HpⅠ型患者(HpⅠ型胃黄色瘤组)132例(83.0%),HpⅡ型患者(HpⅡ型胃黄色瘤组)27例(17.0%);无胃黄色瘤且Hp分型检测结果为Ⅱ型的118例患者作为HpⅡ型无胃黄色瘤组;无胃黄色瘤且Hp核酸检测阴性的217例患者作为对照组。收集各组临床资料并进行比较分析。结果各组患者中慢性非萎缩性胃炎、慢性非萎缩性胃炎伴糜烂或胆汁反流、慢性萎缩性胃炎和胃溃疡患者的比例,HpⅠ型胃黄色瘤组分别为26.5%、40.9%、25.8%和6.8%,HpⅡ型胃黄色瘤组分别为11.1%、44.4%、44.4%和0,HpⅡ型无胃黄色瘤组分别为34.7%、47.5%、10.2%和7.6%,对照组分别为30.4%、55.3%、9.7%和4.6%。HpⅠ型胃黄色瘤组和HpⅡ型胃黄色瘤组慢性非萎缩性胃炎、慢性非萎缩性胃炎伴糜烂或胆汁反流、慢性萎缩性胃炎和胃溃疡患者的比例差异无显著性(P>0.05)。HpⅡ型胃黄色瘤组慢性萎缩性胃炎及胃溃疡患者比例高于HpⅡ型无胃黄色瘤组,差异有显著性(P<0.05)。HpⅡ型无胃黄色瘤组与对照组4类胃黏膜损伤的比例差异无显著性(P>0.05)。结论对于胃镜检查发现胃黄色瘤的患者,应重视对HpⅡ型感染的治疗,HpⅠ型和HpⅡ型感染均建议行根除Hp治疗。

Objective To investigate the relation between gastric xanthelasma, nucleic acid testing of Helicobacter pylori(Hp) and severity of gastric benign diseases. Method From January 2018 to March 2019, 159 cases of gastric mucosal pathological specimens with positive Helicobacter pylori(Hp) nucleic acid and gastric xanthelasma(132 cases with Hp type Ⅰ positive and 27 cases with Hp type Ⅱ positive), 118 cases of gastric mucosal pathological specimens with Hp type Ⅱ positive and without gastric xanthelasma were collected in Beijing Anzhen Hospital, Capital Medical University. Another 217 cases of gastric mucosal pathological specimens with negative Hp nucleic acid and without gastric xanthelasma were set as control group. Genotyping of Hp infection and the presence of gastric xanthelasma were analyzed. Result Rates of chronic non-atrophic gastritis, chronic non-atrophic gastritis with erosion or bile reflux, chronic atrophic gastritis, gastric ulcer were 26.5%, 40.9%, 25.8%, 6.8% in the Hp type Ⅰ positive with gastric xanthelasma group and 11.1%,44.4%, 44.4%, 0 in the Hp type Ⅱ positive with gastric xanthelasma group, respectively. Rates were 34.7%, 47.5%, 10.2%, 7.6% in the Hp type Ⅱ positive without gastric xanthelasma group and 30.4%, 55.3%, 9.7%, 4.6% in control group. The types of gastric diseases showed no significant differences between the Hp type Ⅰ positive with gastric xanthelasma group and Hp type Ⅱ positive with gastric xanthelasma group(P>0.05). The types of gastric diseases showed significant differences between the Hp type Ⅱ positive with gastric xanthelasma group and Hp type Ⅱ positive without gastric xanthelasma group(P>0.05). Rates of chronic atrophic gastritis and gastric ulcer in the Hp type Ⅱ positive with gastric xanthelasma group were higher than those in the Hp type Ⅱ positive without gastric xanthelasma group. The types of gastric diseases showed no significant differences between Hp type Ⅱ positive without gastric xanthelasma group and Hp negative without gastric xanthelasma group(P>0.05). Conclusion Patients detected with gastric xanthelasma and Hp type Ⅰ/Ⅱ infection, especially those with Hp type Ⅱ infection,should undertake Hp eradication therapy.