2018 年第 11 期 第 13 卷

幽门螺杆菌核酸联合分型检测与胃和十二指肠良性疾病严重程度的关系

Relation between nucleic acid testing of Helicobacter pylori and severity of gastric and duodenal benign diseases

作者：杨军郎海波高峰张杰

英文作者：

单位：100029首都医科大学附属北京安贞医院消化内科    

英文单位：

关键词：胃和十二指肠疾病；幽门螺杆菌核酸检测；幽门螺杆菌分型；严重程度

英文关键词：

• 摘要：

• 【摘要】目的    研究幽门螺杆菌（Hp）核酸联合分型检测与胃和十二指肠良性疾病严重程度的关系。方法    针对2018年1—6月在首都医科大学附属北京安贞医院消化内镜中心行胃镜检查的患者，收集其中胃黏膜病理标本幽门螺杆菌核酸检测阳性212例患者的临床资料，进行不同基因分型、不同感染严重程度组间病情资料比较。 结果212例Hp感染患者中Hp Ⅰ型185例（87.3%），Hp Ⅱ型27例（12.7%）。Hp Ⅰ型组185例患者中慢性非萎缩性胃炎、慢性非萎缩性胃炎伴糜烂或胆汁反流、慢性萎缩性胃炎和胃溃疡及十二指肠正常、十二指肠炎和十二指肠溃疡的比例分别为20.0%、23.8%、37.3%、18.9%、51.9%、23.8%、24.3%，Hp Ⅱ型组27例患者分别为29.7%、44.4%、22.2%、3.7%、74.1%、22.2%、3.7%，2组胃黏膜损伤、十二指肠黏膜损伤类型构成差异均有统计学意义（均P<0.05）。Hp Ⅰ型感染按严重程度分为轻度组（17例）、中度组（63例）、重度组（105例），重度组慢性萎缩性胃炎和胃溃疡的比例明显高于轻度组和中度组，慢性非萎缩性胃炎和慢性非萎缩性胃炎伴糜烂或胆汁反流比例明显低于轻度组和中度组，差异均有统计学意义（均P<0.05）。结论    Hp核酸联合分型检测对胃和十二指肠疾病严重程度的判断有一定的临床意义。Hp Ⅰ型感染患者，尤其是重度感染患者建议清除Hp治疗。

• 【Abstract】Objective    To investigate the relation between nucleic acid testing of Helicobacter pylori(Hp）and severity of gastric and duodenal benign diseases. Methods    From January to June 2018, 212 cases of gastric mucosal pathological specimens with positive Helicobacter pylori nucleic acid were collected in Beijing Anzhen Hospital, Capital Medical University. Genotyping and severity of Hp infection were analyzed. Results    There were 185 cases(87.3%) with Hp type Ⅰ and 27 cases(12.7%) with Hp type Ⅱ. Rates of chronic non-atrophic gastritis, chronic non-atrophic gastritis with erosion or bile reflux, chronic atrophic gastritis, gastric ulcer, normal duodenum, duodenitis and duodenal ulcer were 20.0%, 23.8%, 37.3%, 18.9%, 51.9%, 23.8%, 24.3% in the Hp type Ⅰ group and 29.7%, 44.4%, 22.2%, 3.7%, 74.1%, 22.2% 3.7% in the Hp type Ⅱ group, respectively. The types of gastric and duodenal diseases showed significant differences between the Hp type Ⅰ group and Hp type Ⅱ group（P<0.05）. Hp type Ⅰ patients were divided into mild group(17 cases), moderate group(63 cases) and severe group(105 cases). Rates of chronic atrophic gastritis and gastric ulcer in the severe group were higher than those in the mild group and moderate group; rates of chronic non-atrophic gastritis and chronic non-atrophic gastritis with erosion or bile reflux in the severe group were lower than those in the mild group and moderate group(P<0.05). Conclusion    sHp nucleic acid testing has certain clinical significance in judging the severity of gastric and duodenal diseases. Patients with Hp type Ⅰ infection, especially those with severe infection, should undertake Hp eradication therapy.