摘要
目的探讨幽门螺杆菌(Hp)、胃泌素、十二指肠胃化生之间的内在联系及其在溃疡形成中的作用机理。方法前瞻性调查十二指肠溃疡169例的 Hp 感染及十二指肠胃化生情况,检测部分患者的基础血清胃泌素,并与同期29例非溃疡性消化不良进行比较。结果 Hp 检出率、十二指肠炎及胃化生发生率,溃疡者(分别为94.0%,69.7%及75.5%)高于非溃疡者(分别为65.5%,10.3%及3.4%)(P<0.01);平均基础血清胃泌素,Hp 阳性 DU(244.23±68.15 ng/L)与 Hp 阳性非溃疡性消化不良(230.47±73.72 ng/L)无明显差异,但两者均高于 Hp 阴性非溃疡性消化不良(174。75±26.41 ng/L)(P<0.05),随着胃泌素水平增高胃化生有加重的趋势(r=0.573,P<0.05)。结论 Hp 感染、胃泌素释放增加、胃化生三者之间有内在联系,并可能在溃疡形成中起重要作用。
AIMS To study the relationship among Helicobacter pylori(Hp) infection,serum gastrin levels and gastric metaplasia in the duodenum,and their mechanism in ulcer development. METHODS From October 1993 to April 1994,169 patients with active DU were investigated to find out the relations among Hp infection, gastric metaplasia in duodenum and basal serum gastrin level mea- sured in part of them.Twenty-nine patients with non-ulcer dyspep- sia were also studied as controls. RESULTS Hp infection,duodenitis and gastric metaplasia could be found more frequently in DU(94.0%,69.7% and 75.5% respectively)than those in non-ulcer dyspepsia(65.5%,10.3% and 3.4 % respectively)(P<0.01).There was no significant difference in the average basal serum gastrin level between Hp^+ ulcer(244.23 ±68.15 ng/L)and Hp^+ non-ulcer(230.47±73.72 ng/L),but they were higher than in Hp^- non-ulcer(174.75±26.41 ng/L)(P<0. 05).Gastric metaplasia would be more serious in patients with a high basal serum gastrin level(r=0.573,P<0.05). CONCLUSIONS There are inherent relations among Hp infection, serum gastrin increase and gastric metaplasia in the duodenum. These may play an important role in the development of duodenal ulcer.
关键词
十二指肠溃疡
幽门螺杆菌
病理
Helicobacter pylori
duodenal ulcer
metaplasia gastrins
