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目的研究Hp长期感染对胃粘膜病变的转归的影响。方法随防了62例10年前Hp感染患者。并分析对比10年前后Hp感染情况、胃镜和病理组织学变化。结果①363例患者16例(25.4％)Hp转阴,47例(74.6％)Hp持续阳性。②Hp持续阴性者10年前后消化性溃疡(PU)的发生率分别为29.78％和53.19％(P<0.05),Hp转阴者10年前后消化性溃疡(PU)的发生率分别为68.8％和12.5％(P<0.05)③Hp持续阳性者10年前后慢性炎症严重程度积分分别为1.77±0.43和2.13±0.34(P<0.01),肠上皮化生(IM)严重程度积分分别为1.13±0.35和1.63±0.52(P<0.05);Hp转阴者10年前后慢性炎症严重程度积分分别为1.81±0.40和1.31±0.48(P<0.01),肠上皮化生(1M)严重程度积分分别为1.6±0.55和1.4±0.59(P<0.05);Hp持续阳性者10年前后胃粘膜糜烂的发生分别为17.02％和38.29％(P<0.05),IM的发生分别为17.02％和44.68％(P<0.01);Hp转阴者lO年前后IM的发生均为31.25％,胃粘膜糜烂10年后完全消失。结论根除Hp不仅能减轻胃粘膜的炎症程度,而且能阻止肠化的发生和发展。
Objective To study the long-term infection of Hp on the outcome of gastric mucosal lesions. Methods with anti-62 cases of Hp infection 10 years ago. Hp infection, endoscopy and histopathological changes were analyzed and compared 10 years ago. Results ① In 363 patients, Hp was negative in 16 cases (25.4%) and persistent Hp in 47 cases (74.6%). (2) The incidence of peptic ulcer (PU) in patients with persistent Hp ten years later was 29.78% and 53.19%, respectively (P <0.05). The incidence of peptic ulcer (PU) in Hp negative patients after 10 years was 68.8% 12.5% (P <0.05). ③The severity of chronic inflammation in Hp persistent positive patients was 1.77 ± 0.43 and 2.13 ± 0.34 respectively (P <0.01), and the severity of intestinal metaplasia (IM) was 1.13 ± 0.35 and 1.63 ± 0.52 (P <0.05). The severity of chronic inflammation in Hp-negative patients was 1.81 ± 0.40 and 1.31 ± 0.48 respectively (P <0.01), and the scores of severity of intestinal metaplasia (IM) were 1.6 ± 0.55 and 1.4 ± 0.59 respectively (P <0.05). The occurrence of gastric mucosal erosions in those with persistent positive Hp were 17.02% and 38.29% respectively (P <0.05), and those with IM were 17.02% and 44.68% ); Hp negative lO years before and after the occurrence of IM are 31.25%, gastric mucosal erosion completely disappear after 10 years. Conclusion Eradicating Hp can not only reduce the degree of gastric mucosal inflammation, but also prevent the occurrence and development of intestinal metaplasia.