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目的 随访评估根除幽门螺杆菌对慢性胃炎患者胃粘膜病理组织学变化的影响。方法 选择幽门螺杆菌阳性的慢性胃炎病人 ,分为根除组和对照组 ,分别予根除HP治疗和对症治疗。治疗前和治疗结束后半年分别行胃镜检查 ,活检病理组织学检查。比较根除HP前后黏膜病理组织学变化情况。结果 全部 80例病人随机分为根除组 (n =40 )和对照组 (n =40 )。半年后 ,根除组 2 9例HP完全根除 ,对照组 2 7例仍为HP阳性。在根除组 ,黏膜急性炎和慢性炎的组织学积分明显降低 (P <0 .0 0 1) ,肠化生的组织学积分亦有降低 ( P =0 .0 2 1)。而对照组 ,急性炎的组织学积分升高 ( P =0 .0 3 4) ,慢性炎和肠化生未见明显变化 ( P >0 .0 5 ) ,两组的萎缩性病变均无明显变化 (P值分别为 0 .5 3和 0 .64 )。结论 根除HP可使胃粘膜急慢性炎症明显消退 ,减轻并有可能逆转肠化生病变。
Objective To evaluate the effect of Helicobacter pylori eradication on gastric mucosal histopathological changes in patients with chronic gastritis. Methods Helicobacter pylori positive chronic gastritis patients were divided into eradication group and control group, respectively, to eradicate HP treatment and symptomatic treatment. Gastroscopy and biopsy histopathology were performed before treatment and six months after treatment, respectively. The histopathological changes of mucosa before and after eradication were compared. Results All 80 patients were randomly divided into eradication group (n = 40) and control group (n = 40). Half a year later, eradication group 29 cases of HP completely eradicated, 27 cases of control group is still HP positive. In the eradication group, histological scores of mucosal acute inflammation and chronic inflammation were significantly decreased (P <0.01), histological scores of intestinal metaplasia also decreased (P = 0.021). The histological score of acute inflammation increased in the control group (P = 0.0034), but there was no significant change in chronic inflammation and intestinal metaplasia (P> 0.05). There was no obvious atrophy in the two groups (P values were 0.53 and 0.64, respectively). Conclusion Eradication of HP can significantly reduce acute and chronic gastric mucosal inflammation, reduce and may reverse the intestinal metaplasia.