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目的探讨粤东潮汕消化道疾病高发区海尔曼杆菌(Hh)感染状况及其与消化道疾病的关系.方法收集我院连续内镜活检(240例)和手术切除胃标本(43例)共283例,以 Warthin-Starry 银染色,镜检出 Hh 感染者,重新复习病史及切片,结果与临床对比分析.结果在283例中共检出 Hh 感染者41例(14%),幽门螺杆菌感染者(Hp)170例(60%),Hh 与 Hp 混合感染者27例(10%).41例 Hh 感染者伴随胃疾病:消化性溃疡(PU)16例(39%),其中十二指肠溃疡(DU)10例(24%),16例 PU 中有混合感染者13例,其中 DU 又占10例.胃癌6例(15%).单纯慢性胃炎19例(46%),其中浅表性胃炎(CSG)18例,萎缩性胃炎(CAG)1例.其他病变:偶有糜烂、肠化极少,浸润细胞以淋巴细胞、浆细胞为主,亦见嗜酸粒细胞和中性粒细胞.但19例有淋巴滤泡出现,且多有生发中心.细菌形态有短粗和细长2种,有混合存在者.定植于粘膜表面或小凹浅部,偶见于深部,多呈灶性或散在分布,主要在窦部,亦见于体部(12例)和十二指肠及食管.结论 Hh 的检出率明显低于 Hp,但其致病性已得到肯定.本组 Hh 检出率高,与 Hp 混合感染率高,PU 和胃癌伴 Hh 感染率高,可能为粤东地区 PU 和胃癌及慢性胃炎等高发的重要因素之一.检出菌至少有2种形态,提示可能不是一种单一的细菌.
Objective To investigate the relationship between Helicobacter (Hh) infection and gastrointestinal diseases in Chaoshan area of eastern Guangdong Province.Methods A total of 283 gastric biopsy specimens (43 cases) Cases, Warthin-Starry silver staining, microscopic examination of Hh infection, review history and section, the results and clinical comparative analysis.Results Among the 283 cases were detected Hh infection in 41 cases (14%), Helicobacter pylori infection 27 cases (10%) were infected with Hh and Hp, and 41 cases with Hh were accompanied by stomach diseases: peptic ulcer (PU) in 16 cases (39%), including duodenal In 10 cases (24%) with ulcer (DU), there were 13 cases of mixed infection in 16 cases of PU, including 10 cases of DU, 6 cases of gastric cancer (15%), 19 cases of chronic gastritis (46% Gastritis (CSG) in 18 cases, atrophic gastritis (CAG) in 1. Other lesions: occasional erosion, intestinal metaplasia, infiltrating cells to lymphocytes, plasma cells, see also eosinophils and neutrophils However, there were 19 cases of lymphoid follicles, and more germinal centers. Bacterial morphology of short and slender, there are mixed presence. Colonization in the mucosal surface or small shallow concave, occasionally in the deep, mostly in focus Sexual or casual In the distribution, mainly in the sinus, also seen in the body (12 cases) and the duodenum and esophagus.Conclusion Hh detection rate was significantly lower than Hp, but its pathogenicity has been affirmed.The detection rate of Hh in this group High, mixed infection rate with Hp, PU and gastric cancer with Hh infection rate may be one of the most important factors in PU and gastric cancer and chronic gastritis in eastern Guangdong.It has at least two kinds of detected bacteria, suggesting that may not be a Single species of bacteria.