摘要
目的：探讨胃癌前病变病理改变的性质、程度和幽门螺杆菌（ＨＰ）感染及药物治疗与其变化过程的关系。方法：胃镜活检慢性萎缩性胃炎（萎缩）３７例，伴肠上皮化生（肠化）１９例、不典型增生７例，观察其与ＨＰ关系，ＨＰ以Ｇｉｍｅｓａ染色，肠化者以粘液组织化学染色。１９例萎缩伴肠化服德诺２８ｄ加施尔康６个月，ＨＰ阳性者加阿莫西林１４ｄ治疗，常规胃镜查ＨＰ根除率。随访６～３１．５个月复查胃镜及ＨＰ。结果：萎缩、肠化、不典型增生ＨＰ阳性率分别为８６．５％（３２／３７）、７８．９％（１５／１９）和５７．１％（４／７）。１９例萎缩伴肠化ＨＰ根除率为６６．７％（１０／１５），萎缩、炎症、肠化改善有效率分别为６３．２％（１２／１９）、７３．７％（１４／１９）和７８．９％（１５／１９）。其中已根除ＨＰ者分别占６６．７％（８／１２）、７１．４％（１０／１４）和６６．７％（１０／１５），与未根除ＨＰ者炎症与肠化改善例数比较有显著性差异（Ｐ＜０．０１）。结论：胃癌前病变与ＨＰ关系密切，联合抗ＨＰ药物及多种维生素疗法对改善胃癌前病变有效。
bjective: The purpose of the study was to investigate the
relationship between gastric precancerous change and Helicobacter pylori (HP). Methods:
Thirtyseven patients with chronic atrophic gastritis(CAG),19 cases of CAG with intestinal
metaplasia(IM) and 7 cases with atypical hyperplasia were biopsyed by endoscopy to observe
their correlation with HP.The HP positive specimens were stained with Gimesa's dyeing, and
the sections from patients with IM were examined with mucus histochemistry dye.Ninteen
cases of CAG with IM were treated Denol for 28 days and TheragraM for 6 months.The HP(+)
cases were added with Amoxycillin remedy for 14 days.HP eradication was examined by
regular endoscopy.The patients were counterchecked by endoscopy and HP at the followup of
631.5 months. Results: The HP positive rate of patients with CAG,IM and atypical hyperplasia
was found to be 86.5%(32/37),78.9%(15/19) and 57.1%(4/7),respectively.The HP eradication in
19 cases of CAG with intestinal epidermis was detected in 10 of 15 (66.7%). The effective rate of
improvement of atrophy, inflammation and IM was found to be 63.2% (12/19), 73.7% (14/19) and
78.9%(15/19),respectively.The HP eradication rate was found to be 66.7%(8/12), 71.4%(10/14)
and 66.7%(10/15),respectively.These values are of significance(P<0.01) in comparison with
those from noneradication group. Conclusions: There is a close relationship between gastric
precancerous changes and HP.The combined therapy of antiHP drugs with multivitamins is
effective to improve gastric precancerous changes.
出处
《南京铁道医学院学报》
1999年第2期105-107,共3页
Journal of Nanjing Railway Medical College
基金
广州铁路集团公司科技发展计划
关键词
幽门螺杆菌
萎缩性胃炎
肠上皮化生
胃癌
Helicobacter pylori
chronic
atrophic gastritis
intestinal metaplasia
atypical hyperplasia
