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目的 通过对十二指肠溃疡 (DU)患者幽门螺杆菌 (Hp)感染与十二指肠胃上皮化生 (DGM)关系的研究 ,进一步阐明DU的发病机制。方法 检测 12 1例患者的内镜、病理、Hp感染和DGM情况。结果 胃内、十二指肠球部的Hp检出率在DU组分别为 90 4%、40 4% ,非DU组分别为 60 9%、2 9% ,P 均 <0 0 0 1;DGM的检出率在DU组为 92 3 % ,非DU组为 42 0 % ( P <0 0 0 1) ,且前者的DGM程度更重 (P <0 0 0 1) ;胃部Hp阳性者DGM的发生率 ( 73 0 % )显著高于胃部Hp阴性者 ( 3 7 5 % ,P <0 0 0 1) ,DGM( ++)及以上者在Hp阳性组发生率 ( 4 7 2 % )也高于Hp阴性组 ( 2 1 9% ,P <0 0 5 ) ;在十二指肠 ,Hp多定植于DGM区 ,且随着DGM程度的加重 ,Hp检出率呈递增趋势。结论 Hp感染特别是十二指肠Hp定植及DGM是影响DU发生发展的两大危险因素 ;Hp感染与DGM的发生及程度有关
Objective To further clarify the pathogenesis of DU by studying the relationship between Helicobacter pylori (Hp) infection and duodenal gastric epithelial metaplasia (DGM) in patients with duodenal ulcer (DU). Methods Endoscopy, pathology, Hp infection and DGM were detected in 12 1 patients. Results The detection rate of Hp in the duodenum and duodenum in the stomach was 90 4% and 40 4% respectively in the DU group and 60 9% and 29% in the non-DU group respectively (P 0 01 0). DGM The positive rate of DGM in DU group was 92.3%, in non-DU group was 42.0% (P <0.01), and the former was more severe (P <0.01) (73 0%) was significantly higher than that of negative gastric Hp patients (37.5%, P 0 01). The prevalence of DGM (++) and above in Hp positive patients was 47.2% Also higher than that in Hp negative group (21.9%, P <0.05). In the duodenum, Hp was colonized in DGM area more frequently, and the detection rate of Hp showed an increasing trend with the increasing of DGM. Conclusion Hp infection, especially duodenal Hp colonization and DGM are the two major risk factors affecting the occurrence and development of DU; Hp infection is related to the occurrence and extent of DGM