【摘要】 目的 探索胃部疾病与肠上皮化生不同类型及幽门螺杆菌(Hp)感染间的关系；筛选出胃癌高危人群进行跟踪随访和防治干预。方法 对147例胃部不同疾病并有胃黏膜肠化生者做了小肠、结肠化生及完全型、不完全型的分型和Hp检测，观察其相互关系。结果 慢性萎缩性胃炎患者胃黏膜小肠化生(Ⅰ型)检出率67.4%，结肠化生(Ⅱ型)及混合型占32.6%；溃疡病患者Ⅰ型占63.6%，Ⅱ型及混合型占36.4%，两病两型检出率间差异无显著性(P>0.05)；但胃癌患者检出Ⅰ型占35.3%，Ⅱ型及混合型64.7%，与萎缩性胃炎及溃疡病之检出率间差异均有显著性(P<0.05)。Ⅱ型肠上皮化生者Hp阳性率66.0%，较Ⅰ型肠上皮化生者43.2%为高，差异有显著性(P<0.05)。结论 萎缩性胃炎、溃疡病患者肠上皮化生均为Ⅰ型居多，相互间差异无显著性，而胃腺癌患者中肠上皮化生以Ⅱ型居多，尤以Ⅱb为著，Hp感染亦以Ⅱ型者居多。故对肠化生者应加强随访、防治干预，特别对Ⅱb型患者更应重视，以期降低胃癌发生率、提高早期胃癌检出率和生存率。

     【关键词】 胃部疾病；肠上皮化生；幽门螺杆菌

    To study the relationship between intestinal metaplasia and Helicobacter pylori(Hp) infection in various gastric diseases

    XU Yong-zheng,SHENG You-hua,YAO Li-jun,et al.Fenxian Central Hospital,Shanghai 201400,China

    【Abstract】 Objective To investigate the relationship between intestinal metaplasia and Hp infection in various gastric diseases.Methods Biopoy mucosap specimens in 147 patients with various gastric diseases were studied for small intestinal metaplasia (typeⅠ)、colonic metaplasia including complete and incomplete type (typeⅡ).Hp were examined for.Results In specimens of atrophic gastritis,the dectection rate of intestinal metaplasia type Ⅰ was 67.4%,detection rate of type Ⅱ and mixed type was 32.6%;the dectection rate of intestinal metaplasia type Ⅰ in peptic ulcer was 63.6%,type Ⅱ and mixed type was 36.4%.There was no significant difference of intestinal metaplasia between atrophic gastritis and peptic ulcer (P>0.05),and there was no significant difference of intestinal metaplasia between type Ⅰ and type Ⅱ (P>0.05).In speciments of gastric cancer,the dectection rate of intestinal metaplasia type Ⅰ was 35.3%,the detection rate of type Ⅱ and mixed type up to 64.7%.The proportion of different sorts of metaplasia in gastric cancer differend from that in atrophic gastritis and peptic ulcer significantly (P<0.05).The Hp infection rate in intestinal metaplasia type Ⅱ was 66%,significantly higher than that in type Ⅰ (P<0.05).Conclusion Intestinal metaplasia type Ⅰ was mostly found in atrophic gastritis and peptic ulcer;while type Ⅱ,especially type Ⅱb was more likely to be detected in gastric cancer.The Hp infection rate was much higher in intestinal metplasia type Ⅱ than in type Ⅰ.So more attention should be paid to patients with intestinal metaplasia (especially type Ⅱb),and measures such as long term of follow-up surveillance and preventive treatment should be taken to defect early stage gastric cancer and give effective treatment. ......