HELICOBACTER-PYLORI-ASSOCIATED WITH A HIGH PREVALENCE OF DUODENAL-ULCER DISEASE AND A LOW-PREVALENCE OF GASTRIC-CANCER IN A DEVELOPING-NATION
HELICOBACTER-PYLORI-ASSOCIATED WITH A HIGH PREVALENCE OF DUODENAL-ULCER DISEASE AND A LOW-PREVALENCE OF GASTRIC-CANCER IN A DEVELOPING-NATION
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DOI：
10.1136/gut.36.2.198
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发表时间：
1995-02-01
期刊：
影响因子：
24.5
通讯作者：
HAZELL, SL
中科院分区：
文献类型：
--
作者：
HU, PJ;LI, YY;HAZELL, SL
本研究探讨幽门螺杆菌感染与消化性溃疡疾病和胃癌之间的关系，特别是细菌的存在与否、胃炎的分级以及胃窦和氧合粘膜的炎症程度。胃炎的分级和幽门螺杆菌的检测采用悉尼系统组织学确定。在1006例患者中，34.5%患有十二指肠溃疡，3.5%患有胃溃疡，2%患有并存溃疡。大多数患者（50.2%）被归类为非溃疡性消化不良。共有2.4%的患者发生胃癌，另有2例患者发生残端癌。溃疡患者中，87.2%有幽门螺杆菌感染的组织学证据。在排除前四周服用抗生素或铋化合物的患者后，98.9%的十二指肠溃疡病患者、100%的胃溃疡病患者和100%的共存溃疡病患者有幽门螺杆菌感染的证据。在内镜检查前4周未服用抗菌药物的胃癌患者中，83.3%有幽门螺杆菌感染的证据。因此，华南地区十二指肠溃疡发病率高，胃溃疡发病率低，是胃癌死亡率低的地区。幽门螺杆菌、组织学反应和胃十二指肠疾病之间有特定的地形关系。我们的数据表明，一个国家的“发达”或“发展中”地位不能用于预测其人口的上消化道疾病概况。
This study examines the relationship between Helicobacter pylori infection and peptic ulcer disease and gastric cancer - in particular, the presence or absence of bacteria, the grading of gastritis, and the degree of inflammation in the antral and oxyntic mucosae. The grading of gastritis and the detection of H pylori were determined by histology using the Sydney system. Of the 1006 patients examined, 34.5% had duodenal ulcer disease, 3.5% gastric ulcer disease, and 2% with coexistent ulceration. Most patients (50.2%) were classified as having non-ulcer dyspepsia. Altogether 2.4% of patients had gastric cancer and two further patients had carcinoma in the gastric stump. Of the ulcer disease patients, 87.2% had histological evidence of H pylori infection. After patients who had taken antibiotics or bismuth compounds in the preceding four weeks were excluded, 98.9% of the duodenal ulcer disease, 100% of the gastric ulcer disease, and 100% of the coexistent ulcer disease patients had evidence of H pylori infection. In patients with gastric cancer who had not taken antimicrobial agents in the four weeks before endoscopy, 83.3% had evidence of H pylori infection. Thus, there was a high rate of duodenal ulcer disease and a low rate of gastric ulcer disease in southern China, an area of low gastric cancer mortality. There was a specific topographical relationship between H pylori, the histological response, and gastroduodenal disease. Our data suggest that the status of a nation as either ''developed'' or ''developing'' can not be used to predict the upper gastrointestinal disease profile of its population.