特集名 | Helicobacter pylori感染の内視鏡診断 | |
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題名 | Hemoglobin indexの診断への応用 (1) IHbの基礎とその病態学的意義 | |
発刊年月 | 2001年 10月 | |
著者 | 中村 孝司 | 帝京大学医学部第三内科(市原病院内科) |
著者 | 屋嘉比 康治 | 帝京大学医学部第三内科(市原病院内科) |
著者 | 友野 寛樹 | 帝京大学医学部第三内科(市原病院内科) |
著者 | 浅井 和規 | 帝京大学医学部第三内科(市原病院内科) |
著者 | 加藤 眞 | 帝京大学医学部第三内科(市原病院内科) |
著者 | 黒澤 進 | 帝京大学医学部第三内科(市原病院内科) |
【 要旨 】 | H.pylori感染胃粘膜は,除菌により病理学的胃炎の改善とともに体部腺領域の発赤の減少が認められる.このことからH.pylori感染の内視鏡診断には,体部腺領域の発赤の程度を利用することができると考えられ,発赤の客観的評価に粘膜ヘモグロビン・インデックス(IHb)測定を利用することが検討されて,その有用性が示された.本稿ではこの粘膜IHb測定法の実際を述べた. H.pylori感染における粘膜IHbの増加は,粘膜の微小循環の異常によるうっ血の反映と考えられる.これはH.pylori感染による肥満細胞の増加と,それからのヒスタミンなど血管作動性因子の放出によるが,さらにH.pylori感染により増加するインターロイキン-8も,肥満細胞からのヒスタミン分泌を増加させており,これらがH.pylori感染における粘膜IHb増加の機序と考えられる. |
Theme | Endoscopic Diagnosis of Helicobater pylori Infection | |
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Title | The Application of Measurement of Mucosal Hemoglobin Index in Endoscopic Diagnosis of Helicobacter pylori Infection -- Basis of Measurement of Mucosal Hemoglobin Index and Its Pathophysiological Significance | |
Author | Takashi Nakamura | 3rd Department of Medicine, Teikyo University School of Medicine, Ichihara Hospital |
Author | Koji Yakabi | 3rd Department of Medicine, Teikyo University School of Medicine, Ichihara Hospital |
Author | Hiroki Tomono | 3rd Department of Medicine, Teikyo University School of Medicine, Ichihara Hospital |
Author | Kazunori Asai | 3rd Department of Medicine, Teikyo University School of Medicine, Ichihara Hospital |
Author | Shinko Kato | 3rd Department of Medicine, Teikyo University School of Medicine, Ichihara Hospital |
Author | Susumu Kurosawa | 3rd Department of Medicine, Teikyo University School of Medicine, Ichihara Hospital |
[ Summary ] | Helicobacter pylori (Hp) infection induces reddening (hyperemia) of the gastric fundic gland mucosa, and its erradication reduces this finding. On the basis of this phenomenon, endoscopic measurement of hemoglobin concentration in the fundic mucosa was studied as to whether it was effective as an endoscopic diagnostic tool for Hp infection, and its usefulness was confirmed. This paper discussed details of the technical problems with this method. The increasing mucosal hemoglobin index (IHb) in Hp infection is a reflection of the abnormal mucosal microcirculation (congestion). This abnormality derives from increased mast cells in Hp-infected gastric mucosa and this induces the increased release of vasoactive factors, especially histamine, from mast cells. Moreover, Hp infection increases the content of interleukin-8 (IL-8) in the gastric mucosa, and IL-8 also increases the release of histamine from mast cells. This seems to be the mechanism of mucosal IHb increase in Hp-infected fundic mucosa. |