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目的：观察幽门螺杆菌（Ｈ．ｐｙｌｏｎ）阳性消化性溃疡病和慢性胃炎患者Ｈ．ｐｙｌｏｒｉ根除前后胃粘膜病理改变与空 泡毒素（ＶａｃＡ）活性的关系。方法：功能性消化不良伴Ｈ ．ｐｙｌｏｒｉ感染的中国患者７４例，于Ｈ．ｐｙｌｏｎ根除前和４～６周 后作胃镜检查，根据新悉尼病理分级法按半定量记分对治疗前后的胃粘膜病理变化程度进行分级。结果：ＶａｃＡ 菌 检出率为８０％（５９ ７４），消化性溃疡病患音的检出率与慢性胃炎患者无明显差别；ＶａｃＡ＋和 ＶａｃＡ－组患者的 Ｈ．ｐｙｌｏｒｉ 根除率亦无明显差别。根除治疗前，Ｖａｃａ 和ＶａｃＡ－组患者的胃粘膜慢性炎症、活动性、表面上皮损伤、萎 缩、肠化和淋巴滤泡数显无著著差别；治疗后４－６周，两组患者的胃窦粘膜炎症活动性、表面上皮损伤和慢性炎症 程度均明显减轻，尤以前者为著（Ｐ＜０．０００１），ＶａｃＡ 组患者的胃窦部淋巴滤泡数量减少亦梢较ＶａｃＡ 组明显 （Ｐ＝００５１），两组患者的胃粘膜萎缩和肠化程度均无明显好转。结论：中国上消化道疾病患者Ｈ．ｐｙｌｏｎ感染根除前 后的胃粘膜病理改变与ＶａｃＡ活性无明显关系。成功根除Ｈ．ｐｙｌｏｒｉ感染并不引起萎缩和肠化的逆转。
Objective: To observe the H. pylori-positive peptic ulcer disease and chronic gastritis patients H. The relationship between the pathological changes of gastric mucosa and the vacuolating toxin (VacA) activity before and after the eradication of pylori. Methods: Functional dyspepsia with H 74 cases of pylori-infected Chinese patients, in H. Before pylon eradication and 4 to 6 weeks after gastroscopy, according to the New Sydney pathological grading method according to semi-quantitative scoring of gastric mucosal lesions before and after treatment to determine the degree of pathological changes. Results: The detection rate of VacA was 80% (59 74). There was no significant difference in the detection rate of peptic ulcer disease between patients with chronic gastritis and those of VacA + and VacA-group. Eradication rate of pylori also no significant difference. Before eradication treatment, gastric mucosal chronic inflammation, activity, surface epithelial injury, atrophy, intestinal metaplasia and lymphoid follicle number were not different between Vaca and VacA-treated patients. After 4-6 weeks of treatment, gastric Sinus mucosal inflammatory activity, surface epithelial injury and chronic inflammation were significantly reduced, especially in the former (P <0.0001), VacA group of patients with antral lymphoid follicles also reduce the number of more obvious than the VacA group (P = 0051), two groups of patients with gastric mucosal atrophy and intestinal metaplasia no significant improvement. Conclusion: Chinese patients with upper gastrointestinal diseases H. The pathological changes of gastric mucosa before and after eradication of pylon infection had no significant relationship with the activity of VacA. Successful eradication of H. Infection with pylori did not cause atrophy and reversal of intestinal metaplasia.