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目的探讨Ki-67表达及幽门螺杆菌(Helicobacter pylori,H.pylori)在阿司匹林相关性胃黏膜病变中的作用。方法本组阿司匹林相关性胃黏膜病变患者共136例,根据胃镜下表现分为出血组、溃疡组和胃炎组;所有患者均应用快速尿素酶试验检测、病理组织学Giemsa染色及13C尿素呼气试验将136例阿司匹林相关性胃黏膜病变患者分为H.pylori感染阳性组和阴性组,应用免疫组织化学染色对各组病变的增殖细胞核抗原Ki-67表达进行检测。结果在正常胃黏膜上皮组织Ki-67无表达或呈弱阳性表达,平均染色积分为0.125±0.354。在阿司匹林相关性胃黏膜病变中,出血组胃黏膜上皮组织Ki-67平均染色积分为3.916±1.676;溃疡组胃黏膜上皮组织Ki-67平均染色积分为2.174±1.527;胃炎组胃黏膜上皮组织Ki-67平均染色积分为1.394±0.899。出血组胃黏膜上皮组织Ki-67平均染色积分显著高于溃疡组及胃炎组(P<0.05)。H.pylori感染阳性组胃黏膜上皮组织Ki-67平均染色积分为2.275±1.511,H.pylori感染阴性组胃黏膜上皮组织Ki-67平均染色积分为1.588±1.698。H.pylori感染阳性组胃黏膜上皮组织Ki-67染色积分明显高于H.pylori感染阴性组(P<0.05)。结论阿司匹林相关性胃黏膜病变组织中,阿司匹林和H.py-lori均可导致胃黏膜的损伤,促进胃黏膜上皮细胞增殖。
Objective To investigate the role of Ki-67 expression and Helicobacter pylori (H. pylori) in aspirin-related gastric mucosal lesions. Methods A total of 136 patients with aspirin-related gastric mucosal lesions in this study were divided into hemorrhage group, ulcer group and gastritis group according to the results of gastroscopy. All patients were tested by rapid urease test, histopathological Giemsa staining and 13C urea breath test 136 cases of aspirin-related gastric mucosal lesions were divided into positive H.pylori infection group and negative group, immunohistochemical staining of each group of lesions of proliferating cell nuclear antigen Ki-67 expression was detected. Results The expression of Ki-67 in normal gastric epithelium was weakly positive or weakly positive, with an average staining score of 0.125 ± 0.354. In aspirin-related gastric mucosal lesions, the average staining score of Ki-67 in gastric mucosal epithelium in bleeding group was 3.916 ± 1.676; the average staining score of Ki-67 in gastric ulcer group was 2.174 ± 1.527; the gastric mucosal epithelium Ki -67 The average staining integral was 1.394 ± 0.899. The average staining score of Ki-67 in gastric mucosal epithelium in hemorrhage group was significantly higher than that in ulcer group and gastritis group (P <0.05). The average Ki-67 staining score of gastric mucosal epithelium in H.pylori-positive group was 2.275 ± 1.511, while the average staining score of Ki-67 in gastric mucosal epithelium in H.pylori-negative group was 1.588 ± 1.698. The Ki-67 staining score of gastric mucosal epithelium in H.pylori-positive group was significantly higher than that in H.pylori-negative group (P <0.05). Conclusions Aspirin and H. py-lori can both cause gastric mucosal injury and promote the proliferation of gastric mucosal epithelial cells in aspirin-related gastric mucosal lesions.