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目的:观察幽门螺杆菌(Helicobacter pylori,H.pylori)在胃黏膜的感染密度及在胃黏膜层不同深度的分布定植对胃黏膜炎症的影响,探讨H.pylori生物膜在其致病性及对抗生素产生耐药机制中的作用.方法:组织病理学观察158例H.pylori阳性慢性胃炎或消化性溃疡患者的胃黏膜病变活检标本,应用苏木精-伊红染色对胃黏膜炎症程度及活动程度分级并观察H.pylori感染密度,比较两者的相关性.应用免疫组织化学染色观察H.pylori在黏膜表面、胃小凹及浅层腺体的分布,比较胃黏膜层不同深度H.pylori定植情况及其感染密度与炎症的关系.结果:免疫组织化学染色显示H.pylori定植在胃黏膜层表面、小凹及浅层腺体.158例胃黏膜组织,黏膜表面H.pylori(+)41例、(++)38例、(+++)79例;小凹(+)29例、(++)42例、(+++)74例;浅层腺体(+)51例、(++)51例、(+++)39例.胃黏膜表面及小凹H.pylori密度与黏膜炎症程度有相关性(P<0.05);浅层腺体H.pylori密度与黏膜炎症程度无明显相关性(P>0.05).158例胃黏膜组织,黏膜表面H.pylori(+)40例、(++)39例、(+++)79例;小凹(+)29例、(++)41例、(+++)74例;浅层腺体(+)48例、(++)53例、(+++)29例.胃黏膜层表面、小凹及浅层腺体H.pylori密度与胃黏膜炎症活动性均有相关性(P<0.05),H.pylori在胃黏膜层不同深度密度越高胃黏膜炎症活动程度越重.结论:H.pylori可以定植在胃黏膜层表面、小凹和浅层腺体,H.pylori感染密度与胃黏膜炎症程度有相关性.具有细菌数量(感染密度)依赖性的H.pylori生物膜可能参与了其致病性及对抗生素的耐药.
OBJECTIVE: To observe the influence of H.pylori infection density in gastric mucosa and its distribution in gastric mucosa at different depths on the inflammation of gastric mucosa, and to investigate the pathogenicity of H.pylori biofilm Antibiotic resistance mechanism.Methods: Histopathological observation of 158 cases of H.pylori-positive chronic gastritis or peptic ulcer patients with gastric mucosal biopsy specimens, the application of hematoxylin-eosin staining of gastric mucosal inflammation and activity Grading and observation of H.pylori infection density, and compared the correlation between the two.Immunohistochemical staining of H.pylori in the mucosal surface, gastric pits and superficial gland distribution, gastric mucosa at different depths of H.pylori The results of immunohistochemical staining showed that H.pylori was colonized on the surface of gastric mucosa, pits and superficial glands.Among the 158 gastric mucosa and mucosal surfaces, H.pylori (+) colonization was observed, There were 41 cases of (++), 38 cases of (+++), 79 cases of small bowel (+), 42 cases of (++), 74 cases of (+++) , (++) 51 cases, (+++) 39 cases.The gastric mucosal surface and small concave H.pylori density and the degree of mucosal inflammation (P <0.05). There was no significant correlation between H.pylori density and mucosal inflammation in superficial glands (P> 0.05) .158 cases of gastric mucosa, mucosal surface H.pylori (+) 40 cases, (++) 39 cases, (+++) in 79 cases, small concave (+) in 29 cases, (++) in 41 cases, (+++) in 74 cases, superficial gland in 48 cases, ++) in 29 cases.The H.pylori density of gastric mucosa surface, small pits and superficial glands was correlated with gastric mucosal inflammatory activity (P <0.05), the higher the H.pylori density at different depths of gastric mucosa Gastric mucosal inflammation more serious.Conclusion: H.pylori can colonize the surface of the gastric mucosa, pits and superficial glands, H.pylori infection and gastric mucosal inflammation has a degree of correlation with the number of bacteria (infection density) Dependent H. pylori biofilm may be involved in its pathogenicity and resistance to antibiotics.