Prevalence of H pylori associated 'high risk gastritis' for development of gastric cancer in patients with normal endoscopic findings

INTRODUCTION H pylori infection is an established risk factor for development of gastric cancer[1,2]. According to the model of carcinogenesis of the intestinal type adenocarcinoma proposed by Correa, the multi-step development starts from the condition o…     

功能性消化不良与幽门螺杆菌关系探讨

功能性消化不良是一种人群中发病率很高的消化系统症状群，其发病机理未完全阐明，本文通过对２７４２例各类型功能性消化不良患者的胃粘膜的幽门螺杆菌感染情况作分析，发现动力障碍型ＨＰ阳性率６５．３％，溃疡型ＨＰ阳性率７４％，胃食管反流型ＨＰ阳性率２４％，特发型ＨＰ阳性率２１．４％，前两型与后两型的阳性率差异有显著性（Ｐ〈０．０５），而前两型之间阳性率差异无显著性（Ｐ〉０．０５），说明ＨＰ与动力障碍型和溃疡     

Eradication of 'ooHelicobacter pylori'ox : an objective assessment of current therapies

The purpose of the present review was to determine objectively the optimal treatment for the eradication of H. pylori amongst the currently used regimens. A comprehensive literature search provided a data-base relating to the following treatments: dual therapy with an anti-secretory drug plus either amoxycillin or clarithromycin; standard triple therapy, with or without additional anti-secretory drugs; proton pump inhibitor triple therapy; and H₂-receptor antagonist triple therapy. Emphasis was placed on intention-to-treat analyses of eradication rates using all of the available evidence. The criteria used to select the optimal treatment were efficacy (eradication rates), frequency of side-effects, simplicity of the regimen (number of tablets per day and duration of treatment) and cost. The analysis showed that proton pump inhibitor triple therapy (that is, a proton pump inhibitor plus any two of amoxycillin, clarithromycin or a nitroimidazole) was the preferred treatment for the eradication of H. pylori . In particular, the 1-week, low-dose regimen with omeprazole plus clarithromycin plus tinidazole produced the highest eradication rates (>90%) with the lowest frequency of side-effects and at only modest cost.     

用PCR—RFLP和16SrDNA指纹图法分析幽门螺杆菌基因型

本文建立了PCR－RFLP和16srDNA指纹图法．对19株幽门螺杆菌（HP）进行基因型分析：HP尿素酶C基因的PCR扩增产物．分别用HindⅢ、HaeⅢ、AluⅠ酶切，结果显示：每个酶均将19株HP分为3种RFLP图谱．综合HindⅢ，HaeⅢ和AluⅠ酶切结果，19株HP分为10个酶切带型；PCR扩增HP标准株16SrRNA基因，地高辛标记制备550bp探针，19株HPDNA分别经HaeⅢ和EcoRⅠ酶切、电泳后，通过Southern杂交获16SrDNA指纹图，结果显示：HaeⅢ酶切分为14个杂交带型，EcoRⅠ酶切19株HP杂交带型均不同。本实验表明：上述两种方法重复性好，分群力高，可准确有效地对HP作出鉴定并将其分型。19株HP株间存在基因型差异。     

埃索美拉唑三联与奥美拉唑三联疗法治疗Hp阳性十二指肠溃疡对比研究

目的比较埃索美拉唑三联与奥美拉唑三联疗法治疗幽门螺杆菌（Hp）阳性十二指肠球部溃疡的临床疗效。方法将104例经内镜诊断并检测证实Hp阳性的十二指肠球部溃疡患者随机分为两组。埃索美拉唑组（52例）：埃索美托唑20mg＋阿莫西林1g＋克托霉素500mg，每日2次，共7d；奥美拉唑组（52例）：奥美拉唑20mg＋阿莫西林1g＋克拉霉素500mg，每日2次，共7d。疗程结束4周后复查胃镜并检测Hp，观察腹痛缓解率、溃疡愈合率、Hp根除率及用药后的不良反应等。结果埃索美拉唑组第1天和第2天腹痛缓解率分别为34．6％和59、6％，高于奥美托唑组的17.3％和38．5％（P〈0．05）。埃索美托唑组和奥美拉唑组溃疡愈合率分别为92.3％和88．5％，Hp根除率分别为88．5％和82．7％，差异无显著性（P〉0．05）。两组用药后不良反应少，有较好的安全性。结论埃索美拉唑三联疗法治疗Hp阳性的十二指肠溃疡安全有效．腹痛缓解速度优于奥美拉唑三联疗法。     

三联疗法根除幽门螺杆菌治疗对肠道微生态的影响

目的 探讨抗幽门螺杆菌(Hp)治疗对患者肠道菌群状态(肠道微生态)及耐药性的影响。方法 分别称取60例患者治疗前后新鲜粪便0．5g，选择肠道菌群中具代表性的4种需氧菌和6种厌氧菌分别进行需氧和厌氧培养，从培养出的菌落中挑选相同的菌株进行治疗前后药敏试验。结果 (1)治疗后肠道菌群中肠杆菌、葡萄球菌、拟杆菌、双歧杆菌、消化球菌、梭菌、乳杆菌、真杆菌均较治疗前明显降低(P＜0．05)；(2)治疗后肠道菌群中大肠埃希氏菌、消化链球菌、赛氏葡萄球菌、普氏梭杆菌、肺炎致病性链球菌群、产气真杆菌等对庆大霉素、红霉素、环丙沙星、特美丁、头孢噻肟钠等药耐药率明显增加，且存在多重耐药(P＜0．05)；(3)治疗后超广谱β—内酰氨酶阳性的消化链球菌、表皮葡萄球菌、普氏梭杆菌、肺炎致病性链球菌群、赛氏葡萄球菌等较治疗前分别增加26．2％、33．3％、28．6％、35．3％、28．6％。结论 三联抗Hp治疗后肠道菌群失调、耐药菌株的增加、传播与扩散对广大人群存在潜在危险。     

胃镜检查与幽门螺杆菌感染关系的初步探讨

本文用前瞻性连续检测方法，对２６９例患者作胃粘膜ＨＰ检测，且同步对消毒前后的胃镜、有关器械和操作者手套采样，作ＨＰ检测。结果发现，消毒前镜端（含弯曲部）、活检钳、清洁刷、器械管道插口和操作者手套采样标本的ＨＰ阳性率分别达６９．５１％、７３．６０％、８１．６２％、８７．７３％和９７．７２％。目前常规的清洗消毒虽能清除ＨＰ对胃镜的大部分污染，但还存在一些易忽视的环节，这可能在检查中引起医源性感染，应予高度重视。     

幽门螺旋菌菌体蛋白质初步研究

用聚丙烯酰胺凝胶电泳(SDS—PAGE)分析幽门螺旋菌(HP),其超声粉碎和冻融抗原有7条主要蛋白质条带,分子量为71kd、62kd、58kd、51kd、29kd、22kd和12kd。免疫印迹法发现HP100kd免疫性强、特异性高。HP外膜蛋白质分子量主要为71kd、58kd、29kd和12kd,HP不同林之间SDS—PAGE图谱相似,但与空肠弯曲菌和结肠弯曲菌明显不同。超声粉碎和冻融处理HP后主要蛋白质条带相同,冻融抗原制备简单,适宜作为ELISA使用抗原。     

Helicobacter pylori infection and gastric emptying of solids in humans

Helicobacter pylori has been implicated in a number of upper gastrointestinal illnesses. In a controlled study, we have investigated the relationship between H. pylori infection and gastric emptying of solids in two groups of patients with chronic symptoms of dyspepsia. In the first group, 19 patients with non-ulcer dyspepsia and H. pylori infection underwent a standard test of gastric emptying after ingestion of 500 μCi of Tc-labelled chicken liver. The results were compared to a control group of 16 uninfected volunteers. We also studied a second group of 20 patients with previously diagnosed idiopathic gastroparesis for the prevalence of H. pylori infection and its relationship to symptom severity and rates of gastric emptying. In the first group of patients, the half-time of gastric emptying was significantly less among the infected patients compared to the uninfected volunteers (108 ± 9 vs. 142 ± 14 min, P < 0.05). In the second group of patients with gastroparesis, the prevalence of H. pylori was not significantly different among these patients than among 21 age and sex matched controls (20% vs. 38%, P = 0.32). Gastric emptying was markedly slow in all 20 patients in the second group but less so among the four with H. pylori infection. Symptom scores were no different between infected and uninfected patients. We conclude that H. pylori infection is not associated with abnormally slow gastric emptying. On the contrary, gastric H. pylori infection appears to be associated with mildly accelerated emptying of solids compared to normal controls. Idiopathic gastroparesis and dyspepsia related H. pylori infection are separate but sometimes overlapping disorders.     

非溃疡性消化不良的幽门螺杆菌研究

本研究旨在观察幽门螺杆菌（ＨＰ）在非溃疡性消化不良（ＮＵＤ）发病中的作用。结果显示，ＮＵＤ患者ＨＰ阳性率为８３．６％，ＨＰ感染率显著高于健康人（Ｐ＜０．０１）。提示幽门螺杆菌在非溃疡性消化不良发病机制中可能有重要意义。