幽门螺杆菌感染与胃镜下胃炎类型及病理分型的关系

摘要

目的：探讨幽门螺杆菌（ Hp ）感染与胃镜下胃炎类型及病理分型的关系。方法选取2012年2月至2014年5月在上海市宝山区罗店医院实施胃镜检查的患者3457例，对所有患者实施连续性胃镜下黏膜活检，确定患者胃炎类型及病理分型，检测患者的 Hp感染情况，探讨 Hp 感染与胃镜下胃炎类型及病理分型的关系。结果浅表性胃炎、糜烂性胃炎、萎缩性胃炎及其他类型胃炎患者中的Hp阳性率分别为51.99％（1150／2210）、79.17％（821／1037）、72.47％（79／109）和56.01％（56／99），浅表性胃炎的Hp感染率低于萎缩性胃炎和糜烂性胃炎，差异有统计学意义（P ＜0.05）。病理检查示，轻度炎症反应组Hp感染率[47.24％（856／1812）]明显低于中度炎症反应组[68.08％（1009／1482）]（χ2＝144.19，P ＜0.05）和重度炎症反应组[98.77％（161／163）]（χ2＝67.34，P ＜0.05）；Hp阳性患者肠上皮化生[41.50％（842／2029）比10.57％（151／1428）]及上皮类瘤变[8.85％（165／1864）比1.49％（21／1407）]的发生率显著高于未发生肠上皮化生组（χ2＝391.48，P ＜0.05；χ2＝73.06，P＜0.05）。结论 Hp感染会促进胃黏膜发生炎症和萎缩，加重胃黏膜炎症反应的程度，同时可能诱发肠上皮的化生和上皮类瘤变。%Objective To investigate the relationship between the Helicobacter pylori ( Hp ) infection and gastritis type,pathological type under endoscope.Methods Total of 3457 patients diagnosed by gastros-copy in Shanghai Baoshan District Luodian Hospital from Feb.2012 to May 2014 were collected.All patients were diagnosed by mucosal biopsy with continuous endoscopy,the patient′s gastritis type and pathological type were analyzed and the Hp infection was detected among all patients.The correlation between the Hp infection and gastritis type and pathological type under endoscope was analyzed .Results The positive rates of Hp of the patients of gastritis,erosive gastritis,atrophic gastritis and other types were 51.99%(1150/2210),79.17%(821/1037),72.47%(79/109) and 56.01%(56/99),the Hp infection rate of superficial gastritis was lower than that of atrophic gastritis and erosive gastritis ,and the differences were statistically sig-nificant (P<0.05).The infection rate of Hp in mild inflammation group [47.24%(856/1812)] was sig-nificantly lower than that in moderate inflammation group [68.08%(1009/1482)] (χ2 =144.19,P <0.05) and severe inflammatory reaction group [98.77%(161/163)](χ2 =67.34,P<0.05).The rates of intestinal metaplasia [41.50%(842/2029) vs 10.57%(151/1428)] and epithelial neoplasia [8.85%(165/1864) vs 1.49%(21/1407)] of patients with positive Hp infection were significantly higher than that of Hp-negative patients(χ2 =391.48,P <0.05;χ2 =73.06,P <0.05).Conclusion Hp infection may promote the inflammation and atrophy of the gastric mucosa,aggravate gastric mucosal inflammatory response, and induce intestinal epithelial metaplasia and epithelial neoplasia .