Helicobacter Pylori除菌前後における胃粘膜の内視鏡像の変化―短期経過例

Changes of the Endscopic Figure before and after the Treatment of Helicobacter pylori

要旨　従来，Helicobacter pylori（H. Pylori）感染胃粘膜に形態変化があるか否かは明らかにされていない。われわれは除菌による最も著明な変化は胃底腺粘膜のびまん性発赤と胃小区の浮腫様所見の消褪であることを観察してきた．そこで，今回は特に除菌後の胃底腺粘膜について発赤所見を中心に検討した．内視鏡的にみたびまん性発赤は除菌後3か月以内に計83.4％が消褪した．しかし，点状発赤の消失率は43.7％にすぎなかった．胃底腺粘膜の，びまん性発赤の程度と好中球浸潤の強さには有意な相関を認めた．また，客観的な発赤の指標としてHb indexを検討すると，H. Pylori陽性例の胃底腺粘膜においては高値を示し，除菌によって有意に低下した．これらの事実から，胃底腺粘膜のびまん性発赤はH. Pylori陽性の慢性活動性胃炎の極めて重要な指標であると考えられた．

　Until now, it has not been clear if Helicobacter pylori (Hp) would cause a change in the gastric mucosa. We have observed that the most noticeable changes of the gastric mucosa infected by Hp are the diffuse reddening and the edema of the gastric areae of the fundic mucosa. This time we have described the gastric mucosal findings before and after treatment of Hp. There was a clear relationship between the grade of diffuse reddening and the degree of neutrophilic invasion of the gastric mucosa. And the Hb index, which is the objective index of fundic mucosal reddening, revealed in a significantly higher degree in the Hp infected mucosa than after it had been treated. Therefore the diffuse reddening of the fundic mucosa was considered by us to be the most important endoscopic sign of chronic active gastritis.