Atrophic body gastritis: Distinct features associated with Helicobacter pylori infection
Atrophic body gastritis: Distinct features associated with Helicobacter pylori infection
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DOI：
10.1111/j.1523-5378.1997.tb00060.x
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发表时间：
1997-06-01
期刊：
影响因子：
4.4
通讯作者：
Bordi, C
中科院分区：
文献类型：
--
作者：
Annibale, B;Marignani, M;Bordi, C
背景资料。通常，萎缩性体胃炎被认为是一种自身免疫性疾病，其特征是壁细胞抗体的存在。之前对幽门螺杆菌感染作用的研究得出了相互矛盾的结果。这项研究的目的是调查幽门螺杆菌在前瞻性调查人群中的患病率和作用。从326例不明原因贫血或消化不良患者的筛查中得出了一系列连续的67例新诊断的萎缩性体胃炎患者。诊断标准为空腹高胃泌素血症、五肽胃泌素抵抗性酸中毒和体部萎缩的组织学确认。在所有67例患者中，幽门螺杆菌感染通过组织学检查和尿素酶试验进行独立评估。胃底和胃窦黏膜的胃炎程度按悉尼系统分级。同时检测壁细胞抗体和内因子抗体。我们的患者中有26.8%存在Hp的活动性感染，这使我们能够根据功能参数(胃泌素、胃酸分泌、胃蛋白酶原I)和组织学评估来识别身体粘膜损害程度明显较小的患者亚群。在这一亚群中，发现有较高的胃癌家族史。幽门螺杆菌阳性和阴性患者中存在ELF壁细胞抗体的发生率相似(61.1%对69.4%)，且与显著的功能和组织学差异无关。感染的治愈决定了躯体萎缩的明显改善以及高胃泌素血症的减少。在新诊断的萎缩性体胃炎患者中，四分之一的人发现活动性幽门螺杆菌感染，这是氧解腺萎缩的潜在原因。
Background. Usually, atrophic body gastritis has been considered an autoimmune disease characterized by the presence of parietal cell antibodies. Previous investigations into the role of Helicobacter pylori infection have obtained conflicting results. The aim of this study was to investigate the prevalence and role of H. pylori in a prospectively investigated population of patients with corpus-predominant atrophic gastritis.Patients and Methods. A consecutive series of 67 newly diagnosed cases of atrophic body gastritis was derived from a screening of 326 patients with unexplained anemia or dyspepsia. Criteria for diagnosis were fasting hypergastrinemia, pentagastrin-resistant achlorhydria, and histological confirmation of body atrophy. In all 67 patients, H. pylori infection was evaluated independently by histological assay and urease test. The gastritis status of both the fundic and antral mucosa were graded according to the Sydney system. Parietal cell and intrinsic factor antibodies also were determined.Results. Active H. pylori infection was present in 26.8% of our patients and allowed us to identify a patient's subpopulation with a significantly smaller degree of body mucosa damage as shown by functional parameters (gastrin, gastric acid secretion, pepsinogen I) and histological assessment. In this subpopulation, a higher prevalence of gastric cancer familial history was found. Presence elf parietal cell antibodies showed a similar prevalence in H. pylori-positive and H. pylori-negative patients (61.1% vs. 69.4%) and was not associated with significant functional and histological differences. Cure of infection determined an evident improvement of corporal atrophy as well as a reduction of hypergastrinemia.Conclusion. Active H. pylori infection, a potential cause of oxyntic gland atrophy, is found in one-fourth of patients with newly diagnosed atrophic body gastritis.