老年人胃黏膜肠上皮化生与幽门螺杆菌感染相关性分析

摘要

Objective To evaluate the relationship between intestinal metaplasia (IM) and helicobacter pylori infection in elderly patients with chronic gastritis. Methods The patients over 60 years old and diagnosed as chronic gastritis by endoscopy from January 2008 to December 2009 were divided into two groups by pathological appearance. One group was chronic gastritis with IM (IM group), the other was chronic gastritis without IM (NIM group). The infection of helicobacter pylori, activity of inflammation, atrophy of gland, and folliculus lymphaticus in gastric mucosa were observed. Results The infection of helicobacter pylori, infiltration of neutrophil and atrophy ratio of gland were significantly higher in IM group than in NIM group (52.7% vs. 37.3%, 35.5% vs.24.0 %, 36.6 % vs. 3.5%, x2 = 10. 677, 7.641, 95. 606; P = 0. 001, 0. 006, 0. 000, respectively).There was no statistical difference in presentation of folliculus lymphaticus between IM group and NIM group (x2 = 0.003, P=0. 957). The infiltration of neutrophil and presentation of folliculus lymphaticus were significantly higher in helicobacter pylori positive patients than in helicobacter pylori negative patients (45.8% vs. 14.8%, 42.6% vs. 4.2%, both P=0.000). Conclusions The appearance of IM seems to be related with helicobacter pylori infection, activity inflammation and atrophy of gland. The presentation of folliculus lymphaticus seems to be closely related with helicobacter pylori infection. The eradication treatment of helicobacter pylori infection in the elderly chronic gastritis patients should be strengthened.%目的 了解老年慢性胃炎患者肠上皮化生与幽门螺杆菌感染之间的相关关系.方法 2008年1月至2009年12月在本院接受胃镜检查的60岁及以上的慢性胃炎患者499例,根据病理结果分为肠化生组186例和非肠化生组313例,分别观察每组胃黏膜的幽门螺杆菌(Hp)感染、中性粒细胞浸润、腺体萎缩、淋巴滤泡等病理表现.结果 肠化生组与非肠化生组比较,Hp感染率(52.7%对37.3%)、中性粒细胞浸润率(35.5%对24.0%)、腺体萎缩率(36.6%对3.5%)均明显升高(x2值分别为10.677、7.641、95.606,均P＜0.01);淋巴滤泡检出率(21.0%对20.8%),两组差异无统计学意义(x2=0.003,P=0.957).Hp感染者中性粒细胞浸润(45.8%)、淋巴滤泡检出率(42.6%),均高于Hp阴性组(14.8%、4.2%),差异均有统计学意义(均P=0.000).结论 胃黏膜肠上皮化生与Hp感染、中性粒细胞浸润、腺体萎缩有相关性,淋巴滤泡形成与Hp感染密切相关,应加强对老年慢性胃炎患者幽门螺杆菌的根治.