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背景:幽门螺杆菌(H.pylori)感染是慢性萎缩性胃炎(CAG)最重要的致病因素,根除H.pylori能否阻止或逆转胃黏膜萎缩目前尚不清楚。目的:通过观察CAG患者H.pylori根除前后胃黏膜G细胞数量和血清胃泌素含量的变化,探讨H.pylori感染对胃黏膜G细胞数量及其分泌功能的影响。方法:60例H.pylori阳性的CAG患者进行了根除治疗,在治疗前和治疗结束3个月后分别行胃镜检查。采用免疫组织化学法和放射免疫分析法测定H.pylori根除前后胃窦黏膜G细胞数量和血清胃泌素含量。结果:31例H.pylori感染的CAG患者在根除治疗3个月后进行了复查,根除率为77.4%。G细胞数量和血清胃泌素含量随胃黏膜萎缩程度的加重而逐渐显著减少(P<0.01)。轻度萎缩组H.pylori根除后G细胞数量与治疗前相比无显著差异(P>0.05),而升高的血清胃泌素含量显著降低(P<0.01);中、重度萎缩组H.pylori根除后减少的G细胞数量显著增加(P<0.05),血清胃泌素含量呈上升趋势(P>0.05)。结论:CAG患者根除H.pylori后胃黏膜G细胞数量及其合成、分泌胃泌素的功能可出现恢复性变化,可能有助于阻断CAG的进一步发展。
BACKGROUND: H. pylori infection is the most important causative agent of chronic atrophic gastritis (CAG). Whether eradication of H. pylori can prevent or reverse gastric mucosal atrophy is not clear. OBJECTIVE: To investigate the effect of H.pylori infection on the number and secretion of G-cells in gastric mucosa by observing the changes of gastric mucosal G cell number and serum gastrin levels before and after H. pylori eradication in CAG patients. Methods: Sixty H.pylori positive CAG patients were treated with eradication therapy. Gastroscopy was performed before treatment and three months after the end of treatment, respectively. Immunohistochemistry and radioimmunoassay were used to determine the amount of G cells and serum gastrin in gastric antral mucosa before and after H. pylori eradication. Results: 31 cases of H.pylori-infected CAG patients were reviewed after 3 months of eradication therapy and the eradication rate was 77.4%. The number of G cells and serum gastrin decreased gradually with the degree of gastric mucosa atrophy (P <0.01). There was no significant difference in the number of G cells after eradication of H.pylori between mild and severe atrophic groups (P> 0.05), but the level of serum gastrin decreased significantly (P <0.01). The number of G cells decreased after the eradication of pylori was significantly increased (P <0.05), and the serum gastrin level was increased (P> 0.05). Conclusions: The number of gastric mucosal G cells, the ability of their synthesis and secretion of gastrin in CAG patients after eradication of H.pylori may show recoverable changes, which may help to block the further development of CAG.