论文部分内容阅读
目的研究十二指肠溃疡（ＤＵ）的胃镜下和组织学愈合是否受球部幽门螺杆菌（Ｈｐ）感染的影响。方法对７０例活动期ＤＵ（Ａ）和４０例瘢痕期ＤＵ（Ｓ组）患者溃疡边缘粘膜活检标本采用快速尿素酶试验和改良姬姆萨染色检测Ｈｐ，并对粘膜固有层内中性多形核白细胞（ＰＭＮ）浸润状态进行观察。结果Ｓ组和Ａ组Ｈｐ阳性率各为６００％和７１４％，差异无显著性（Ｐ＞０．０５）。Ｓ组和Ａ组中Ｈｐ阳性者ＰＭＮ浸润率和ＰＭＮ计数（各为９１７％；２０３±０．５１和１０００％；２３４±０．４０）分别明显高于（Ｐ均＜００１）其Ｈｐ阴性者（各为５６３％；０６７±０．２９和６５０％；１１１±０．３２）。在Ｈｐ阳性者，Ｓ组ＰＭＮ浸润率和ＰＭＮ计数均与Ａ组相近（Ｐ＞０．０５）；在Ｈｐ阴性者，Ｓ组仅ＰＭＮ浸润与Ａ组相近（Ｐ＞０．０５），其ＰＭＮ计数则明显低于Ａ组（Ｐ＜０．０１）。结论ＤＵ的胃镜下愈合可不受球部Ｈｐ感染的影响，但后者与溃疡边缘粘膜活动性炎症密切相关从而使ＤＵ的组织学愈合质量明显受其影响。
Objective To investigate whether endoscopic and histological healing of duodenal ulcer (DU) is affected by Helicobacter pylori (Hp) infection in the bulb. Methods Peripheral mucosal biopsies from 70 patients with DU (A) and 40 patients with DU (S) were examined by rapid urease test and modified Giemsa staining for Hp. Nuclear leukocyte (PMN) infiltration was observed. Results The positive rates of Hp in group S and group A were 60.0% and 71.4% respectively, with no significant difference (P> 0.05). The PMN infiltration and PMN count of Hp positive patients in group S and group A (917%, 203 ± 0.51 and 1000%, 234 ± 0.40) were significantly higher than those in group P All <001) had negative Hp (563%, 067 ± 0.29 and 650%, 111 ± 0.32 respectively). In Hp positive patients, the infiltration rate and PMN count of PMN in group S were similar to that of group A (P> 0.05). In Hp negative group, only PMN infiltration in group S was similar to that of group A (P> 0.05) The count was significantly lower than the A group (P <0.01). Conclusions The gastroscopic healing of DU is not affected by Hp infection in the bulb, but the latter is closely related to active inflammation of mucosa at the marginal ulcer and thus the quality of histological healing of DU is significantly affected.