19 research outputs found
Morphological changes of the gastric mucosa in patients with duodenogasric reflux: relationship with acidity and helicobacter pylori
Purpose: to reveal the peculiarities of the duodenogastric reflux (DGR) impact on acidity and morphological features of the gastric mucosa in patients with "primary" reflux gastritis, as well as in cases of reflux gastritis in combination with H. pylori. Methods: 66 patients with chronic reflux gastritis were examined, 15 people formed a control group. All patients had gastric endoscopy with determination of the gastric acidity and concentration of bile acids. Biopsy material for histological examination was obtained from 55 patients, in 12 cases of suspected intestinal metaplasia additional histochemical (PAS and alcian blue) and immunohistochemical (cytokeratin 20, Villin, carcinoembriogenic antigen, MUC2, CD45) assays were performed. Results: the level of acidity in patients with DGR was higher (pH = 3.55 Β± 2.3) compared to the control group (pH = 6.85 Β± 1.34). Cases of DGR differed from the control group regarding the mononuclear infiltration (p=0,001), foveolar hyperplasia (p=0,001) in both antral and fundic parts of the stomach, mucosal edema (p=0,022) and atrophy (p=0,02) at the level of the antrum, and intestinal metaplasia (p=0,022) at the level of the body. In the presence of H. pylori infection, in addition to the abovementioned signs, infiltration by cells of acute inflammation (p = 0.005) was detected, which indicates an increase in the damaging effect of H. pylori infection in DGR. Conclusion: DGR may lead to "oxidation" of gastric contents. The effect of DGR leads to intestinal metaplasia of the body and atrophy of the antral part of stomach, chronic inflammation and foveolar hyperplasia. The presence of H. pylori boosts the morphological changes in the gastric mucosa caused by DGR.Π¦Π΅Π»Ρ: Π²ΡΡΠ²ΠΈΡΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ Π²ΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΡ Π΄ΡΠΎΠ΄Π΅Π½ΠΎΠ³Π°ΡΡΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ»ΡΠΊΡΠ° (ΠΠΠ ) Π½Π° ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ ΡΠ»ΠΈΠ·ΠΈΡΡΠΎΠΉ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠΈ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° ΠΏΡΠΈ Β«ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΌΒ» ΡΠ΅ΡΠ»ΡΠΊΡ-Π³Π°ΡΡΡΠΈΡΠ΅, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅, Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ H.pylori, ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΡ ΡΠ²ΡΠ·Ρ ΠΠΠ Ρ ΡΡΠΎΠ²Π½Π΅ΠΌ ΠΊΠΈΡΠ»ΠΎΡΠ½ΠΎΡΡΠΈ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ: ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΎ 66 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ΅ΡΠ»ΡΠΊΡ-Π³Π°ΡΡΡΠΈΡΠΎΠΌ, 15 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ Π³ΡΡΠΏΠΏΡ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ. ΠΡΠ΅ΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΡΠ·ΠΎΡΠ°Π³ΠΎΠ³Π°ΡΡΡΠΎΠ΄ΡΠΎΠ΄Π΅Π½ΠΎΡΠΊΠΎΠΏΠΈΡ Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ΠΌ ΠΊΠΈΡΠ»ΠΎΡΠ½ΠΎΡΡΠΈ ΠΈ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ ΠΆΠ΅Π»ΡΠ½ΡΡ
ΠΊΠΈΡΠ»ΠΎΡ Π² ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎΠΌ ΡΠΎΠ΄Π΅ΡΠΆΠΈΠΌΠΎΠΌ. 55 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΠΈΠΎΠΏΡΠΈΠΉΠ½ΠΎΠ³ΠΎ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π° ΡΠ»ΠΈΠ·ΠΈΡΡΠΎΠΉ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠΈ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ°, ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠΉ ΠΌΠ΅ΡΠ°ΠΏΠ»Π°Π·ΠΈΠΈ 12 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ Π³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠ΅ (ΠΎΠΊΡΠ°ΡΠΊΠ° Π¨ΠΈΡΡ-ΠΉΠΎΠ΄Π½ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΠΎΠΉ ΠΈ Π°Π»ΡΡΠΈΠ°Π½ΠΎΠ²ΡΠΌ ΡΠΈΠ½ΠΈΠΌ) ΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠ΅ (ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΠΈ ΡΠΈΡΠΎΠΊΠ΅ΡΠ°ΡΠΈΠ½Π° 20, Π²ΠΈΠ»Π»ΠΈΠ½Π°, MUC2, ΡΠ°ΠΊΠΎΠ²ΠΎΠ³ΠΎ ΡΠΌΠ±ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ Π°Π½ΡΠΈΠ³Π΅Π½Π°, CD45) ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅. ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ: Π£ΡΠΎΠ²Π΅Π½Ρ ΠΊΠΈΡΠ»ΠΎΡΠ½ΠΎΡΡΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠ Π±ΡΠ» Π²ΡΡΠ΅ (ΡΠ=3,55Β±2,3) ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π³ΡΡΠΏΠΏΠΎΠΉ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ (ΡΠ=6,85Β±1,34). ΠΠ· ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΠΏΡΠΈ Π΄ΠΡ Π·Π½Π°ΡΠΈΠΌΠΎ ΠΎΡΠ»ΠΈΡΠ°Π»ΠΈΡΡ ΠΎΡ Π³ΡΡΠΏΠΏΡ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ ΠΌΠΎΠ½ΠΎΠ½ΡΠΊΠ»Π΅Π°ΡΠ½Π°Ρ ΠΈΠ½ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΡ (Ρ=0,001), ΡΠΎΠ²Π΅ΠΎΠ»ΡΡΠ½Π°Ρ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΡ (Ρ=0,001) Π² ΠΎΠ±ΠΎΠΈΡ
ΠΎΡΠ΄Π΅Π»Π°Ρ
ΠΆΠ΅Π»ΡΠ΄ΠΊΠ°, ΠΎΡΠ΅ΠΊ (Ρ=0,022) ΠΈ Π°ΡΡΠΎΡΠΈΡ (Ρ=0,02) Π°Π½ΡΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π°, ΠΊΠΈΡΠ΅ΡΠ½Π°Ρ ΠΌΠ΅ΡΠ°ΠΏΠ»Π°Π·ΠΈΡ (Ρ=0,022) Π½Π° ΡΡΠΎΠ²Π½Π΅ ΡΠ΅Π»Π° ΠΆΠ΅Π»ΡΠ΄ΠΊΠ°. ΠΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ H. pylori, ΠΏΠΎΠΌΠΈΠΌΠΎ ΡΠΆΠ΅ Π²ΡΡΠ²Π»Π΅Π½Π½ΡΡ
ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ², Π²ΡΡΠ²Π»ΡΠ΅ΡΡΡ ΠΈΠ½ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΡ ΠΊΠ»Π΅ΡΠΊΠ°ΠΌΠΈ ΠΎΡΡΡΠΎΠ³ΠΎ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ (Ρ=0,005), ΡΡΠΎ ΡΠ²ΠΈΠ΄Π΅ΡΠ΅Π»ΡΡΡΠ²ΡΠ΅Ρ ΠΎΠ± ΡΡΠΈΠ»Π΅Π½ΠΈΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π°ΡΡΠ΅Π³ΠΎ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ H. pylori ΠΏΡΠΈ ΠΠΠ . ΠΡΠ²ΠΎΠ΄Ρ: ΠΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ ΠΠΠ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ Β«ΠΎΠΊΠΈΡΠ»Π΅Π½ΠΈΡΒ» ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠΎΠ΄Π΅ΡΠΆΠΈΠΌΠΎΠ³ΠΎ. ΠΠΎΠ·Π΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ ΠΠΠ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠΉ ΠΌΠ΅ΡΠ°ΠΏΠ»Π°Π·ΠΈΠΈ ΡΠ΅Π»Π° ΠΈ Π°ΡΡΠΎΡΠΈΠΈ Π°Π½ΡΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ΄Π΅Π»Π° ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° Π½Π° ΡΠΎΠ½Π΅ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΠΎΡΠΏΠ°Π»Π΅Π½ΠΈΡ ΠΈ ΡΠΎΠ²Π΅ΠΎΠ»ΡΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΠΈ. ΠΡΠΈΡΡΡΡΡΠ²ΠΈΠ΅ H. pylori ΡΡΠΈΠ»ΠΈΠ²Π°Π΅Ρ Π²ΡΠ·Π²Π°Π½Π½ΡΠ΅ ΠΠΠ ΠΌΠΎΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠ»ΠΈΠ·ΠΈΡΡΠΎΠΉ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠΈ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ°