- 期刊
Evaluation of the Severity of Helicobacter Pylori Infection with Urease Test: Its Correlation with Histopathology and Bacterial Density
以尿素酶評估幽門螺旋桿菌感染嚴重度：其與細菌密度及發炎反應之相關性
摘要
幽門螺旋桿菌（簡稱 H . Pylori ）之感染已被認為是胃炎的主要原因之一，而尿素醃法是檢測 H . pylori 感染快速而準確的方法。本研究之主要目的是評估尿素醇法是否能作為反應 H . Pylori 感染嚴重程度的指標。共有 69 位接受胃鏡檢查之病人（男 39 人，女 30 人，平均年齡 39 . 7±15.3 歲），其中 32 位為非潰瘍性消化不良， 37 位為瘢痕期潰瘍病人。在胃鏡檢查中，以切片鉗夾取胃竇大小彎及胃角處組織作尿素醉測定，玻片組織壓印之革蘭氏染色及病理 H : E 染色。將尿素酣法之反應時問定為 0 級（ 6 小時內仍未變色），一級（ 3 至 6 小時內變色），二級（ 30 分至 3 小時內變色），三級（ 30 分鐘內變色）。病理組織之發炎反應分為零級（發炎細胞平均占視野 50 ％以下），一級（ 50-75 % ) ，二級（ 75 ％以上）。革蘭氏染色下細菌密度分為三級（平均高倍每個視野下至少 4 株以上），二級（平均 1-3 株），一級（所有視野下 1-10 株） , 0 級（看不到 H . Pyfori ）。結果發現尿素醇法之反應時問與組織發炎反應及細菌密度皆無相關。結論：內視鏡切片之尿素醃測定法可以判定 H . Pylori 感染之有無及發炎反應之存在與否，但無法作為評估 H . Pylori 感染嚴重程度之指標。
關鍵字
無資料並列摘要
In 69 patients, the severity of Helicobactor pylon (H. pylon) infection was evaluated by bacterial density of tissue implants and inflammatory responses by histology. The specimens were taken from gastric angle and antrum (greater and lesser curvature sides) by gastroduodenal endoscopy. In urease test, the severity was measured in 3 grades according to color change of the agar: those change are within 30 minutes (grade 3), 30 minutes to 3 hours (grade 2), and 3 to 6 hours (grade 1), respectively; while the grade 0 indicated no color change occurring 6 hours after tissue inoculation. The severity of infection was assessed according to the bacterial density under high power microscopic fields (Gram’s stain). Grade 0 indicated no bacterium seen; grade 1, only 1 to 10 bacteria at all fields; grade 2, 1 to 3 bacteria in each high power field; and grade 3 was 4 bacteria or more on average in each high power field. The degree of inflammatory response was evaluated by inflammatory cell infiltration (H & E stain) and classified into grade 0, 1 and 2, which indicated the inflammatory cell infiltration below 50%, between 50% and 75%, and above 75%, respectively. There are no positive relationships among urease test reaction time, bacterial density grading and degrees of inflammatory cell infiltration. Clinically, the reaction time of urease test cannot reflect the severity of H. pylon infection semi-quantitatively, either in terms of bacterial density or cellular inflammatory response.