2017 年第 10 期 第 12 卷

消化性溃疡临床病理特征及其与幽门螺杆菌感染的关系

Relation between clinicopathological features of peptic ulcer and helicobacter pylori infection

作者：秦耿王慧芬白如雪王秀红杜时雨

英文作者：Qin Geng Wang Huifen Bai Ruxue Wang Xiuhong Du Shiyu

单位：100029北京，中日友好医院消化内科(秦耿、王慧芬、白如雪、杜时雨),病理科(王秀红)

英文单位：Department of Gastroenterology China-Japan Friendship Hospital Beijing 100029 China(Qin G Wang HF Bai RX Du SY); Department of Pathology China-Japan Friendship Hospital Beijing 100029 China(Wang XH)

关键词：消化性溃疡；螺杆菌，幽门；胃镜

英文关键词：Pepticulcer;Helicobacterpylori;Gastroscopes

• 摘要：

• 目的 探讨消化性溃疡临床病理特征及其与幽门螺杆菌（Hp）感染的关系。方法 回顾性分析2013年6月至2016年6月在中日友好医院行电子胃镜确诊的230例消化性溃疡患者的临床资料。经过Hp感染检验，根据患者是否Hp感染，分为Hp（-）组和Hp（+）组。电子胃镜观察消化性溃疡的临床病理特征，分析消化性溃疡的临床病理特征及其与Hp感染的关系。结果 Hp感染检查结果显示，Hp（-）组 55例和Hp（+）组 175例。Hp（+）组服用非甾体消炎药比例低于、而上腹疼痛比例高于Hp（-）组（均P<0.05）。230例消化性溃疡患者中胃溃疡75例（32.6%）、十二指肠溃疡123例（53.5%）、复合溃疡32例（13.9%）。十二指肠溃疡主要在球前壁及大弯部位，胃溃疡主要在胃角及胃窦部位，复合溃疡主要在球前壁及胃窦部位。Hp（+）组胃溃疡比例低于，而十二指肠溃疡、黏膜炎性反应为重度、炎性反应活动性重度比例高于Hp（-）组［25.7%（45/175）比54.5%(30/55)、62.9%（110/175）比23.6%(13/55)、45.7%（80/175）比27.3%(15/55)、57.1%（100/175）比27.3%(15/55)］，差异均有统计学意义（均P＜0.05）。结论 溃疡病变类型以十二指肠溃疡最多，胃溃疡次之，消化性溃疡临床病理特征改变与Hp感染密切相关。

• Objective To investigate the relation between clinicopathological features of peptic ulcer and helicobacter pylori（Hp） infection. Methods Clinical data of 230 patients diagnosed of peptic ulcer by electronic gastroscopy from June 2013 to June 2016 in China-Japan Friendship Hospital were analyzed retrospectively. According to results of Hp infection test, the patients were divided into Hp(-) group and Hp(+) group. Clinical and pathological features of peptic ulcer were observed. The relationship between peptic ulcer and Hp infection was analyzed. Results There were 55 cases in Hp(-)group and 175 cases in Hp(+) group. The use ratio of non-steroidal anti-inflammatory drugs in Hp(+) group was significantly lower and the epigastric pain ratio was significantly higher than those in Hp(-) group(P＜0.05). Among 230 cases of peptic ulcer, 75 cases(32.6%) were gastric ulcer, 123 cases(53.5%) were duodenal ulcer and 32 cases(13.9%) were complex ulcer. Duodenal ulcer mainly located in anterior wall and greater curvature; gastric ulcer mainly located in gastric angle and antrum; complex ulcer mainly located in anterior wall and gastric antrum. The gastric ulcer ratio in Hp(+) group was significantly lower than that in Hp（-） group; ratios of duodenal ulcer, severe mucositis and active severe inflammation in Hp(+) group were significantly higher than those in Hp（-） group［25.7%（45/175） vs 54.5%(30/55), 62.9%（110/175） vs 23.6%(13/55), 45.7%（80/175） vs 27.3%(15/55), 57.1%（100/175） vs 27.3%(15/55)］（P＜0.05）. Conclusion Peptic ulcer mainly locates in duodenal and gastric mucosa; clinicopathological features of peptic ulcer are closely related to Hp infection.