文摘

背景——幽门螺杆菌感染胃粘膜在十二指肠溃疡疾病的发病机理是至关重要的。H螺杆菌只会殖民胃上皮细胞及其与十二指肠疾病协会因此不容易解释。目标,以确定在十二指肠胃化生儿童十二指肠溃疡疾病的风险增加了感染H幽门。病人——所有儿童接受胃镜检查在20个月期间在儿童医院在爱尔兰。方法——两个活检标本经窦的粘膜和两个从十二指肠的第一部分。窦的活检标本之一是用于快速尿素酶试验(Clo测试)。活检部分被苏木精和伊红染色,也对甲苯基紫H幽门的识别。高碘酸希夫(PAS)染色进行识别领域的胃化生。结果——胃和十二指肠活检标本来自148个病人(F M: 1:2:1)。二十个五个孩子(17%)H螺杆菌积极的胃炎。 Thirty four children (23%) had gastric metaplasia in the duodenum. Nine per cent of children under the age of 8 years had gastric metaplasia compared with 38% in those 12 years of age or over (p < 0.005). Seven children had duodenal ulcer disease. Gastric metaplasia was present in six of seven (86%) children with duodenal ulcer disease compared with 28 of 141 (20%) without ulceration (p < 0.001). While both H pylori and gastric metaplasia were each significant risk factors for duodenal ulcer disease, the combined presence of both factors was associated with a pronounced increase in duodenal ulcer disease. Duodenal ulcer disease occurred in over 50% of children with both H pylori infection and gastric metaplasia. In contrast duodenal disease did not occur in children (0 of 100) when both were absent. CONCLUSION--The presence of gastric metaplasia in the duodenum is the major risk factor for duodenal ulcer disease in patients colonised by H pylori.