30例Ba工rrett食管内镜下特点及.doc

30例Barrett食管内镜下特点及 与幽门螺杆菌感染关系的研究 孙永刚，唐子美，谭绪云，刘学军，杨小毛，杜选峰，王辉 赵倩 郑倩 解放军第535医院消化内科，湖南 怀化 418000 【摘要】 目的　探讨30例Barrett食管(BE)的内镜下特点及与幽门螺杆菌(H. pylori)感染的关系。方法 采用胃镜检查结合病理检查结果对30例BE患者进行分析，同时选取反流性食管炎及正常食管粘膜各50例作为对照组，采用快速尿素酶法及Warthin-Starry银染两种方法检测Hp感染。结果　30例BE中，以短段、舌型发病率最高,分别占83.33%和66.67%; 组织学上，胃底型12例（40%），贲门型10例（33.33%），特殊肠化生型8例（26.67%）。食管部Hp的检出率，BE组阳性率明显高于反流性食管炎组和正常食管粘膜组( P﹤0.05)。胃窦部Hp的检出率，BE组显著低于反流性食管炎组和正常食管粘膜组(P﹤0.05)。结论 本组BE病例内镜下以短段、舌型为主，Hp对BE可能有保护作用。 关键词　Barrett食管; 幽门螺杆菌；内镜 The endoscopic characteristies of Barrett esophagus and relationship with Helicobacter pylori infection in 30 cases SUN yonggang, TANG zimei, TAN xuyun, LIU xuejun, YANG xiaomao, DU xuanfeng， WANG hui，ZHAO qian, ZHENG qian. Department of Gastroenterology, 535 of PLA, Huaihua 418000 , China Abstract：AIM: To discuss the endoscopic characteristies of Barrett esophagus (BE) and the relation between BE and Helicobacter pylori infection in 30 cases. METHODS: 30 BE were analyzed by gastric endoscopies and historical methods, meanwhile, 50 reflux esophagitis(RE) and 50 normal persons as control groups, The prevalence of Hp infection was determined by rapid urease test and Warthin-Starry staining RESULTS: In 30 BE, short segment and tongue type BE were most common (83.33% , 66.67% ), There were fundic type(40% )，cardia type(33.33% ) and intestinal metaplasia type(26.67% ) in histology. The prevalence of Hp infection in esophagus was significantly higher in patients with BE than that in RE and normal esophagus( P﹤0.05). The prevalence of Hp infection in antrum was significantly lower in patients BE than that in RE and normal esophagus( P﹤0.05). CONCLUSION: Most of BE are short segment and tongue type, Hp may have protective effect for Barrett esophagus. [ Key words] Barrett esophagus; Helicobacter pylori; Endoscope Barrett 食管（Barrett esophagus, BE）是指食管下段的复层鳞状上皮被单层柱状上皮所替代的一种病理现象，可伴肠化生或不伴肠化生，其中伴有特殊肠化生者属于食管腺癌的癌前病变[1]。幽门螺杆菌(Helicobacter pylori , Hp) 的感染与慢性胃炎、消化性溃疡、胃癌和胃MALT淋巴瘤等消化系统疾病密切相关，世界卫生组织已把幽门螺杆菌列为Ⅰ