胃炎におけるHelicobacter Pylori除菌前後の内視鏡像の変化―長期経過例

Changes of Endoscopic Gastritis after Curing of Helicobacter pylori Infection in Long-term Follow-up Patients

要旨　Helicobacter Pylori（H. Pylori）除菌に成功した長期経過観察80例を対象として，除菌前後の内視鏡的胃炎像の変化をSydney Systemに準じて検討した．その結果，胃体上部から胃底部にかけてみられる点状発赤の改善，粘膜ひだ肥厚の改善，結節性変化の改善，血管透見の明瞭化がH. Pylori除菌に伴う内視鏡変化と考えられた．血管透見の明瞭化については，組織学的な炎症所見の消失による2次的な内視鏡変化の可能性が推測された．

　To determine endoscopic features of Helicobacter pylori-related gastritis, we examined changes of endoscopic gastritis after curing of H. pylori infection in long-term follow-up patients. The objects were 80 patients who had eradication treatment of H. pylori more than one year previously for various gastroduodenal disease. The endoscopic features before and after eradication were assessed according to endoscopic division of the Sydney System. Improvement of fine-erythema in the upper body and cardia, rugal hyperplasia in the upper body, and nodularity in the antrum and body were observed after curing of H. pylori infection. Their features were thought as H. pylori-related gastritis. Exacerbation of endoscopic visibility of vascular pattern was also observed. However, histological atrophy didn't change after eradication treatment. Its changes may be due to the disappearance of inflammatory cells in the gastric mucosa. Raised erosion, flat erosion, linear-erythema, patchy-erythema, and bleeding spots were not associated with H. pylori induced gastritis.