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目的:了解儿童和成人各个年龄段人群感染Hp后的胃粘膜病理变化特点及探索其可能的发病机制。方法:对40例儿童和45例成人Hp相关性胃炎病人的病理变化作回顾性分析。结果:儿童Hp相关性胃炎的病理变化以浅表炎症为主,而在成人年龄越大,萎缩性胃炎的比例越高,两者比较差异显著(x~2=11.93,P<0.005)。成人组胃粘膜炎症中中性粒细胞的比例明显高于儿童组,两者比较差异显著(x~2=31.17,P<0.005)。成人组胃粘膜固有腺体萎缩和肠上皮化生也明显高于儿童组(分别为x~2=11.93,P<0.005,x~2=11.84,P<0.005)。而儿童组淋巴滤泡形成明显高于成人组,两者比较差异显著(x~2=5.89,P<0.025)。结论:各年龄段人群感染Hp后在胃粘膜病理变化上存在着差异,随着年龄增大,急性炎症越明显,胃粘膜萎缩及肠上皮化生的发生率亦越高。提示Hp感染存在某种与年龄相关的宿主方面反应上的差异。
Objective: To understand the pathological changes of gastric mucosa in children and adults of all ages infected with Hp and to explore its possible pathogenesis. Methods: The pathological changes in 40 children and 45 adults with Hp-related gastritis were retrospectively analyzed. Results: The pathological changes of Hp-related gastritis in children were mainly superficial inflammation. The higher the adult age, the higher the proportion of atrophic gastritis, the difference was significant (x ~ 2 = 11.93, P <0.005). The proportion of neutrophils in gastric mucosal inflammation in adults was significantly higher than that in children (x ~ 2 = 31.17, P <0.005). The gastric mucosal intrinsic glandular atrophy and intestinal metaplasia were also significantly higher in adults than in children (x ~ 2 = 11.93, P <0.005, x ~ 2 = 11.84, P <0.005). However, the formation of lymphoid follicles in children group was significantly higher than that in adult group (x ~ 2 = 5.89, P <0.025). Conclusion: There are differences in pathological changes of gastric mucosa between Hp infected patients of all ages. With age, acute inflammation is more obvious, gastric mucosal atrophy and intestinal metaplasia are higher. Suggesting that Hp infection has some difference in age-dependent host response.