Patterns of colonisation of Campylobacter pylori in the oesophagus, stomach and duodenum.
Patterns of colonisation of Campylobacter pylori in the oesophagus, stomach and duodenum.
复制标题
幽门弯曲杆菌在食道、胃和十二指肠中的定植模式。
作者：
S. Walker;P. Birch;M. Stewart;C. Stoddard;C. Hart;D. W. Day
35例患者接受了上消化道内窥镜检查和多次活检(30例患者，5例正常人)。对来自四个部位(食道(3个)、胃体(2个)、胃窦(3个)、十二指肠(3个))的11例活检标本进行了炎症和幽门弯曲菌的检查，并采用标准的培养方法以及光镜和电子显微镜观察。30例患者中有8例(27%)的食道活检组织中培养出这种微生物，但通过光镜或扫描电子显微镜无法在该部位进行鉴定。有20例患者有食管炎的证据，这与5例(25%)局部发现幽门螺杆菌有关，包括7例Barrett‘s粘膜中的2例(29%)。在23例慢性活动性胃炎患者中，22例(96%)存在胃窦部C幽门螺杆菌。22例患者中4例(18%)在胃窦和食道发现细菌，22例患者中4例(18%)在胃窦和十二指肠内发现细菌，22例患者中有2例(9%)在所有三个部位均发现细菌。6例消化性溃疡患者中有5例发现胃窦C幽门螺杆菌。6例患者经十二指肠培养，3例经LN和EM证实，但仅在胃化生部位培养。正常组未发现该微生物。提示在胃窦部和慢性活动性胃炎患者的食道和十二指肠中可能存在C-Pylori的不规则分离。幽门螺杆菌在食道中的作用很可能是共生菌或污染物。
Thirty five subjects underwent upper gastrointestinal endoscopy and multiple biopsy (30 patients, five normal subjects). A total of 11 biopsies per subject from four sites (oesophagus (three), gastric body (two), antrum (three), duodenum (three] were examined for inflammation and the presence of Campylobacter pylori and using standard methods of culture and by light (LM) and electron microscopy (EM). The organism was cultured from oesophageal biopsies in eight of 30 (27%) patients but could not be identified at this site by LM or EM. There was evidence of oesophageal inflammation in 20 patients which was associated with the local finding of C pylori in five (25%) including two of seven (29%) with Barrett's mucosa. Antral C pylori was present in 22 of 23 (96%) patients with chronic active gastritis. The organism was found in the antrum and oesophagus in four of 22 patients (18%), in the antrum and duodenum in four of 22 patients (18%) and in all three sites in a further two of 22 patients (9%). Antral C pylori was found in five of six patients with peptic ulceration. C pylori was cultured from the duodenum in six patients with confirmation by LN and EM in three, but only on areas of gastric metaplasia. The organism was not found in the normal group. This study indicates that C pylori may be irregularly isolated from the oesophagus and duodenum in patients with antral C pylori and chronic active gastritis. The role of C pylori in the oesophagus is most likely that of a commensal or contaminant.