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幽门螺杆菌球形变的鉴定及其对根除治疗的临床意义

Identification of coccoid forms of Helicobacter pylori and their clinical significance for eradication therapy
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摘要 目的探讨幽门螺杆菌(Helicobacter pylori, H.pylori)发生球形变的相关因素及其与胃黏膜病理变化之间的关系。方法纳入2020年1月至2021年6月就诊于宁夏回族自治区人民医院的66例H.pylori感染者。收集患者的临床资料, 对胃黏膜标本进行免疫组织化学染色, 观察H.pylori球形变发生情况和胃黏膜组织病理改变。统计学分析采用χ^(2)检验。结果 66份H.pylori感染者的胃黏膜标本经免疫组织化学染色后, 26份(39.39%)发现H.pylori球形与螺旋形共存, 未发现单纯H.pylori球形变。有H.pylori根除治疗史的患者球形变发生率为52.63%(20/38), 高于无根除治疗史患者的21.43%(6/28), 差异有统计学意义(χ^(2)=6.57, P=0.012)。不同性别、民族、年龄、胃黏膜病理改变(包括萎缩、胃肠上皮化生、炎症、活动性)患者的H.pylori球形变发生率差异均无统计学意义(均P>0.050)。23例胃镜检查距离末次根除治疗时间>1~3个月的患者中17例(73.9%)发生H.pylori球形变, 而15例胃镜检查距离末次根除治疗时间>3个月的患者中3例发生球形变, 差异有统计学意义(χ^(2)=10.59, P=0.002)。结论 H.pylori球形变的转化与既往根除治疗有关, 球形H.pylori相对于螺旋形H.pylori同样具有致病性。 Objective To investigate the factors associated with the occurrence of coccoid forms in clinical isolates of Helicobacter pylori(H.pylori)and its relationship with the pathological changes of gastric mucosa.Methods A total of 66 H.pylori-infected patients admitted to People′s Hospital of Ningxia Hui Autonomous Region from January 2020 to June 2021 were included.The clinical data of the patients were collected.Immunohistochemical staining was performed on gastric mucosal biopsy specimen to observe the occurrence of coccoid forms of H.pylori and pathological changes of gastric mucosa.Chi-square test was used for statistical analysis.Results After immunohistochemical staining of 66 gastric mucosa biopsy specimens from H.pylori-infected patients,the co-existence of helical and coccoid forms of H.pylori was found in 26(39.39%)specimens,and no simple coccoid H.pylori change was found.Among them,the patients with a history of eradication therapy had a coccoid forms rate of 52.63%(20/38),and those without a history of eradication therapy had a coccoid forms rate of 21.43%(6/28),and the difference was statistically significant(χ^(2)=6.57,P=0.012).There were no significant differences in the coccoid forms rates between patients with different gender,ethnicity,age and gastric mucosal pathological changes(including atrophy,gastric intestinal metaplasia,inflammation,activity)(all P>0.050).Seventeen(73.9%)of the 23 patients whose endoscopy was more than one to three months from the last eradication therapy developed coccoid forms,while three of 15 patients whose endoscopy was more than three months from the last eradication therapy had coccoid forms,and the difference was statistically significant(χ^(2)=10.59,P=0.002).Conclusions The transformation of H.pylori coccoid forms is related to the previous eradication therapy.The coccoid forms of H.pylori is equally pathogenic relative to the helical forms of H.pylori.
作者 周燕 牛敏 李雪 李西梅 苏小明 郜恒骏 呼圣娟 白飞虎 Zhou Yan;Niu Min;Li Xue;Li Ximei;Su Xiaoming;Gao Hengjun;Hu Shengjuan;Bai Feihu(School of Clinical Medicine,Ningxia Medical University,Yinchuan 750000,China;Department of Gastroenterology,People′s Hospital of Ningxia Hui Autonomous Region(Ningxia Medical University Affiliated People′s Hospital of Autonomous Region),Yinchuan 750000,China;Department of Gastroenterology,Tongji Hospital,Tongji University,Institute of Digestive Disease,School of Medicine,Tongji University,Shanghai 200120,China;Department of Gastroenterology,The Second Affiliated Hospital of Hainan Medical University,Haikou 570216,China)
出处 《中华传染病杂志》 CAS CSCD 2022年第11期668-672,共5页 Chinese Journal of Infectious Diseases
基金 海南省临床医学中心(2021818) 宁夏回族自治区重点研发计划项目(2019BFG2003)。
关键词 幽门螺杆菌 球形 免疫组织化学 病理学 根除治疗 Helicobactor pylori Coccoid forms Immunohistochemistry Pathology Eradication therapy
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