老年人慢性胃炎程度与幽门螺杆菌的关系

来源 :浙江中西医结合杂志 | 被引量 : 0次 | 上传用户:ntzhou
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目的:探讨老年人慢性胃炎病理组织学特征和慢性炎症程度与幽门螺杆菌感染的关系。方法:经胃镜检查和病理学检测诊断为慢性胃炎患者1089例,按年龄<60岁(非老年组)与≥60岁(老年组)分成两组。均用快速尿素酶试验(KUT)检测Hp,并行HE染色作组织学诊断和炎症程度的评价。结果:同组中,中度以上炎症的Hp感染率高于轻度炎症者,老年组Hp感染率61.29%,非老年组67.34%,两组间差异无显著性意义。慢性活动性胃炎Hp感染率,老年组78.65%,非老年组82.35%,两组间差异无显著性意义,但各自均高于同组的慢性炎症、萎缩、肠化生及不典型增生的Hp感染率。老年组慢性炎症的Hp阳性率20.28%,明显低于非老年组的41.27%,与同组的萎缩、肠化生及不典型增生的Hp阳性率(分别为35.07%、37.36%、46.67%)相比,差异有显著性意义,P<0.01。结论:慢性炎症程度直接与Hp感染密切相关,且不随着年龄的增长而加重。无论是老年组还是非老年组,Hp感染都是慢性活动性胃炎的重要致病因素,而且可能在炎症的初始阶段发挥作用。老年人胃黏膜病理组织学变化与Hp感染具有相关性。 Objective: To investigate the relationship between histopathology and chronic inflammation of chronic gastritis and Helicobacter pylori infection in the elderly. Methods: A total of 1089 patients with chronic gastritis diagnosed by gastroscopy and pathology were divided into two groups according to age <60 years (non-elderly group) and> 60 years old (elderly group). Rapid urease test (KUT) were used to detect Hp, parallel HE staining for histological diagnosis and evaluation of the degree of inflammation. Results: In the same group, Hp infection rate was higher than mild inflammation in moderate and severe inflammation. Hp infection rate was 61.29% in the elderly group and 67.34% in the non-elderly group. There was no significant difference between the two groups. Hp infection rate of chronic active gastritis was 78.65% in the elderly group and 82.35% in the non-elderly group, but there was no significant difference between the two groups, but each was higher than that of chronic inflammation, atrophy, intestinal metaplasia and atypical hyperplasia in the same group Infection rate. The Hp positive rate of chronic inflammation in the elderly group was 20.28%, which was significantly lower than that of the non-elderly group (41.07%, 35.07%, 37.36%, 46.67%, respectively) Compared with the difference was significant (P <0.01). Conclusion: The degree of chronic inflammation is directly related to Hp infection and does not aggravate with age. Hp infection is an important causative agent of chronic active gastritis both in the elderly and non-elderly groups, and may play a role in the initial stage of inflammation. Histopathological changes in gastric mucosa of the elderly are associated with Hp infection.
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