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该研究旨在探讨HP感染的慢性胃炎和消化性溃疡患者HP根治前后胃粘膜中胃肠激素Gas、SS、SP及G、D、EC1细胞变化和其相关性。方法 :1997年 3月～ 1999年 12月对 10 2例HP感染的病人 ,HP根治前后分别用放射免疫法及免疫组化染色图像定量分析Gas、SS、SP含量和G、D、EC1细胞密度、灰度。结果 :HP阳性的三组病人经药物治疗根治后胃粘膜Gas含量均较治疗前明显降低 (P <0 .0 1) ,SS、SP含量较治疗前升高 (P<0 .0 1,P <0 .0 5 )。图像定量分析示HP根治前后胃粘膜G、D、EC1细胞密度显著降低 (P <0 .0 5 ) ,D、EC1细胞灰度增加 (P <0 .0 5 )。结论 :三组病人HP根除后胃粘膜Gas减少 ,G细胞灰度降低 ,SS、SP升高 ,D、EC1细胞灰度增加 ,细胞分泌颗粒变化与粘膜相应激素变化呈正相关。提示HP感染干扰了这些激素分泌释放的调控 ,可能是HP相关性胃炎和消化性溃疡的发病机制之一。根除HP后SS、SP升高 ,Gas降低纠正HP感染所致的这些激素分泌释放紊乱 ,可能是HP根除后溃疡复发率降低的原因之一。在HP根除前SP ,EC1细胞灰度降低 ,根除后升高 ,提示SP抑制胃泌素分泌释放 ,而对生长抑素无抑制作用 ,具有胃粘膜保护功能。
The purpose of this study was to investigate the changes of gastrointestinal hormones Gas, SS, SP and G, D, EC1 in gastric mucosa of patients with chronic gastritis and peptic ulcer before and after HP infection. Methods: From March 1997 to December 1999, 102 patients with HP infection were treated with radioimmunoassay and immunohistochemical staining respectively before and after HP to quantitatively analyze the contents of gas, SS and SP and the cell density of G, D and EC1 , Grayscale. Results: The gas content of gastric mucosa in three groups of patients with HP positive were significantly lower than those before treatment (P <0.01), and the contents of SS and SP were higher than those before treatment (P <0.01, P <0 .0 5). Quantitative image analysis showed that the density of G, D and EC1 cells in gastric mucosa before and after HP radical injection were significantly decreased (P <0.05), and the gray values of D and EC1 cells increased (P <0.05). CONCLUSION: After gastric mucosal HP eradication, the gastric mucosal Gas decreased, the G cell gray level decreased, the SS and SP increased, the D and EC1 cell gray level increased. The change of cell secretory granules was positively correlated with the corresponding hormone changes of mucosa. Suggesting that HP infection interferes with the regulation of the secretion of these hormones and may be one of the pathogenesis of HP-associated gastritis and peptic ulcer. After the eradication of HP, SS, SP increased, Gas reduced to correct HP infection caused by these hormone secretion and release disorders may be one of the reasons for the reduction of ulcer recurrence after HP eradication. In the pre-eradication of HP, the gray level of EC1 cells decreased and then increased after eradication, suggesting that SP inhibits the secretion of gastrin without inhibiting the somatostatin and has the protective function of gastric mucosa.