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为探讨小儿十二指肠胃上皮化生的产生机理及其临床意义，对３１５例疑诊为上消化道疾病患儿的十二指肠球部活检粘膜标本做胃上皮化生（ＧＭ）及幽门螺杆菌（Ｈｐ）的组织学检测，并应用免疫组化法测定ＧＭ后胃窦部促胃酸激素产生细胞（Ｇ细胞）密度。结果显示，小儿十二指肠球部ＧＭ率为１２．１％（３８／３１５），活动性十二指肠炎组ＧＭ率和十二指肠球部Ｈｐ感染率为５０．０％（１５／３０）及１６．７％（５／３０），十二指肠球部溃疡组ＧＭ率和十二指肠球部Ｈｐ感染率为５２．４％（１１／２１）及２３．８％（５／２１），而慢性十二指肠炎和正常十二指肠球部粘膜组ＧＭ率仅占７．３％（１１／１５０）及０．９％（１／１１４）；且十二指肠球部未见Ｈｐ感染。胃窦部Ｈｐ阳性组十二指肠球部中重度ＧＭ率显著高于胃窦部Ｈｐ阴性组（χ２＝２７．３７，Ｐ＜０．０１），中重度ＧＭ其胃窦Ｇ细胞密度显著高于正常对照组（ｔ＝３．２０，Ｐ＜０．０１）。提示ＧＭ、Ｈｐ感染与小儿活动性十二指肠炎及十二指肠溃疡形成有较密切关系。但ＧＭ率及十二指肠球部Ｈｐ感染率均较成人低。中重度ＧＭ的发生与胃窦部Ｈｐ感染及Ｇ细胞密度增高有关。
In order to explore the mechanism and clinical significance of duodenal gastric epithelial metaplasia in children, 315 cases of gastric mucosa of the duodenal biopsy in children suspected to be upper gastrointestinal diseases were treated with gastric epithelial metaplasia (GM) and pylorus Helicobacter pylori (Hp) histological examination, and application of immunohistochemical method after gastric antral GM gastrin-producing cells (G cells) density. The results showed that the GM rate in children with duodenal bulb was 12.1% (38/315), the GM rate in active duodenitis group and the Hp infection rate in duodenal bulb were 50.0% (15 / 30) and 16.7% (5/30) respectively. The rates of GM and duodenal Hp infection in duodenal ulcer group were 52.4% (11/21) and 23.8% (5) / 21), while the rates of GM in chronic duodenitis and normal duodenal mucosa accounted for only 7.3% (11/150) and 0.9% (1/114) respectively; and duodenal bulb Department no Hp infection. The moderate to severe GM rate in duodenal area of Hp positive group was significantly higher than that in Hp negative area of gastric antrum (χ2 = 27.37, P <0.01). The density of G cells in gastric antrum was significantly higher in moderate and severe GM In the normal control group (t = 3.20, P <0.01). Tip GM, Hp infection and children with active duodenitis and duodenal ulcer formation are more closely related. However, the GM rate and the rate of Hp infection in duodenal bulb were lower than those in adults. The occurrence of moderate and severe GM and gastric antrum Hp infection and G cell density increased.