Title: ?????? ?????? (?????? ?????????????) Helicobacter Pylori (H.Pylori)
1?????? ?????? (?????? ?????????????)Helicobacte
r Pylori (H.Pylori)
- LECTURE
- ON
- Helicobacter Pylori
- By
- DR. ISLAM SABRY KANDEL
- (M.B., B. Ch.)
- MASTER DEGREE IN
- CLINICAL AND CHEMICAL PATHOLOGY
- Faculty of Medicine
- Cairo University
2?????? (??????? ??????)
- ?????-???? ??????? ?????? ???? ??? ???? ????
???????? ???????? ???? ????? ??????? ????? ??????
???????? ??? ??? ??? ????? ????? ?? ?????. - ??? ?????? ?? ??????? ??????....
- ??? ?????....
- ??????.
3?? ??? ????? ??? ??? ???? ???? (??? ???? ????
????)- ?????? ??? ?????? ??????? ????? ??????
???? ??? ?????? ???? ?????? ?????? ????? ????
?????? ???? ?????? ?????? .
4????? ??????
- ?????? ?? ??? ????? ????? ????? ?????? ???????
???? ???? ???? ?? ??????? ???? ???????? ???????
???? ????? ???? ?? ????? ????? ???? ?????? ??????
??? ????? ???????. - ????? ??????? ??????? ?? ?????? ????????? ???????
???????? ? 12. - ?????25?? ??????12?? ??????? 1300?? ?????? ??
??????? ??????? ???? ?? 4 ????? ????? ??? ??????. - (??? ???? ???? ???? ?? ??) ???? ??????????88
-
5?????? ?????? ( H.Pylori )
6??? ?????? ?????? ??????-
- ?????? ??????( H.Pylori )?? ???? ???? ????? ??
?????2-4 ?????? ?????? 1 ??????(Grame negative
spiral shaped Urease producing bacterium)
7???????? ???????????????
8?????? ????????
- ??????? ???????? ??????????? (???? ?????? ? ?????
?????) ??? 1983? ??? ???? ???????? ????? ???? ??
???? ??? ????? ?? ??? ???????? ?????.
9?????? ?????? ??????
-((Epidemiology ???? ???? ??????)???? ?? 90 ??
???????? ?? ??????? ???????) ?????? ???? ????????
10??????
- ???? ?????? ?? ???? ??? ?????? ??????? ?????????
?? ????? ???????? ???????? ????? ?????? ?????.
11????? ????? ?????? ????????
- ???? ????? ???????? ??? ????? ????? ??? ??????
??? ??? ???-1 -???????. - 2-????? ?????? ?????.
- 3-??????? ?????? ?????????? ???????.
- 3-?????? ?????? ??????.
12????? ?????? ?? ???? ??????
- 1- ???? ?????? ?????? ????? ????????Urease ?????
???? ?????? ???? ??????? ??? ?????? ??????????
??? ???? ????? ???? ??? ??????? ???? ???? ?????
????? ??????? ?????? ??? ????? ??. - -2- It possesses a proton pump.
13?????? ??????
14???? ????? ?????? ????????!
- ???? ?????? ?????? ?? ??????? ???????? ?????
?????? ????? ???????? ??????? ??????? ??????
???????(???? ??????) ???????? ?????? ??? ????????.
15????????!
- ??? ?????? ?????? ?????? ?? ??????? ???????? ????
???? ??????? ???????? ???? ???????? ??????
??????? ?? ??????? ?????????(Neutrophils)
???????? ??????? (Eosinophils)????????
????????(Basophils) ??? ???? ?????????? ???????
?? ???? ??????.
16??? ????? ?????? ??????
- 1-????? ?????? ??? ???? ?????.
- 2-??? ????? ????? ?? ????? ???? ?????.
- 3-?????? ?????? ?????? ?????? ????? ?????.
- 4-????? ?????? ???????? ????? ???? ??? ????
???????.
17????? ?????? ??????
- ???? ???? ???????? ???? ?????? ???????? ??????
?????? ?? ?????? ??????? ???? ???? ????? ???????
?????? ??????? ??? ?????? ?? ?????? ????? ???????
?? ??? ????????????? ????? ??????.
18??? ???? ???????
- ???? ?????? ?????? ?????? ??? ?????? ???? ????
?????? ??? - 1-VacA (Vacuolating toxin)
- 2-Cag A(Cytotoxic associated protein)
19???? ??????
20???? ?????? ???
21??????? ??? ???????? ????????!
- ?? ????? ?????? ?????? ?????? ????? ?????
???????? ?? ??? 1994? ???? ????? ????? ??????. - ????? ?????? ???? ??? ???????? ??????? ??????
??? 1-Gastric adenocarcinoma - 2-Gastric B cell Lymphoma
22????????
23???? ?????? ?????? ??????
24????????
- Diagnosis of Helicobacter Pylori Infection
- A- Invasive Methods (Endoscopy)-
- ??? ?????-????????-???????
- 1-Rapid Urease Test-
- 2-Culture-
- 3-Histology-
25- Invasive Methods
- (Endoscopy)
- 1- ?? ??? ????? ??? ??? ???? ?? ?????? ????????
?????? ????? ?? ???????? . - 2-???? ???????? ???????? ???? ?????93-95.
- 3-???? ??????? ??? ?? ???? ?????? ?? ?????? ??
??????? ???? ?? ????? ??? ????? ?????? ????? ???
?? ????? ???? ????? ??? ??????? ?????? ??? ????
????? ???? ????? ?? ???????? . - -
-
-
26?????? ???????? ?????? Rapid Urease Test
- ???? ?????? ???????? ?? ?????? ???????? ?? ?????
???????? ??????? ??? ??????? ?????? . - 2-?? ???? ???? ???????? ????? ???? ???????? ??
??????? ?????? ????????(Urease) ?????? ???? ?????
???????? ?????? ???? ????(100 ??? ?? ?????? ????)
?????? ???????? ????? ??? ??????? ??????.
27 ????? ??????? ??????? ?????? Culture
Sensitivity Test
28??? ????? ?????? ??? ??? ???? ???????? Histology
29????????
- Diagnosis of Helicobacter Pylori Infection
- B-Non Invasive Methods
- (Serological tests)-?????????? ??????? 1-
- Stool Test ))?????? ?????? ?????? ??????? 2-
(Urea breath test)?????? ?????? ?????? ??????
3-
30?????????? ??????? ??????
- ????? ??? ?????????? ?? ?????? ??????? ????
?????? ???? ?????? ??????? ?????? ????? ????????
??? ??? ?????? ?? ?????? ????? ?? ???? ???????
??????? ???????? ??? ?????? ?????? ??????
??????(Rapid H. Pylori) ?? ?????? ????
????????(ELISA).
31?????? ?????? ?????? ?????? ?????? Stool Test For
H.Pylori
- ?????? ????? ????(Qualitative Immunoassay)
- ????? ?? ???????? ?? ?????? (???????? ???????? ??
90-95) ??????? ?????? ??????? ???????? ??????. - ???? ????????-
- 1-??? ??? ???????(12 ????).
- 2-?????? ??? ????? ???????.
- 3-???? ???? ??????? (?? 48 ???? -72????).
32?????? ???????? ?????? ( Urea Breath Test )
- ??? ???? ????? ???????? ???? ?????? ??????
??????? ??????? ?????? ????? ????? ??????? ??
?????? ?????? ?????? (???????? ???????? ???????
?? 98-100). - ?????? ???? ???????-
- 1-??? ??? ??????? (20 ?????) ????? ???? ???????
(5 ?????). - 2- ??? ?????? ??? ????? ??????? (??? ??????? ???
???? ????? ??????). - 4- ?????? ???? ?? ??????? ??????? ?????????
?????? ? ??? ???? ???????? ??? ????? ??? ???? ??
?? ? ???? ?????? ? ???? ?????? ??? ?????? ?
33?????? ???????? ?????? ( Urea Breath Test )
- ????? ???????? ?????? ??????? ????? ?????
?????????? ????? ???? ???????? ?????? ??????
?????? ????? ??? (????? urea) ?? 50 ?? ???.
34?????? ???????? ?????? ( Urea Breath Test )
- ??? ???? ???? ???????? ???? ???????? ?????? ?????
(Urease) ????? ???? ?????? ??????? ???urea ?????
??????? ????? ((C13 ?? ???? ???????.
35?????? ???????? ?????? ( Urea Breath Test )
- ??? ??? ????? ???? ?????? ?????? ?? ??? ??? ????
??? ?????.
36?????? ???????? ?????? ( Urea Breath Test )
- ????? ??? ??????? ?????? ????? ?????? ???????
????? ??? ????? ?? ???? ???? ??? ???? Mass
Spectrometer ?????? ?? ???? ???????? ? ??????
?????? ???? ?????.
37???? ?????? ????? Urea Breath Test
- 1-??? ?? ???? ?????? ?????? ???? ???? ?????.
- 2-?????? ???? 1-2 ????? ?? ??? ???????? ???????
(???? ????? ????????) ??????? ??????? ?? ??????
?????? ????? ???????? ( (ppi???
Lansoprazol, Omeprazole
38???? ?????? ?????? ?????? ?? ???? ?????
- 1-????? ??????? ??? ???? ???? ???????????
???????? ???? ?? ??? ???? ??????? ??????? ????
??????? ?????? ?????? ???? ?????? . - 2-?????? ??? ??? ???????? ??? ??? 3 ?????.
-
39?????? Treatment
- ????? ?????? (??? ???? ???? ????) ???????? ????
?????? ???? ???? ??? ???? ?? ???? ??? ??? ??? ??
???? ??? ?????.
40?????? ???????
? ???? ?? ????? ??????? ???? ??? ?????? (???
?????? ?? ????? ???????? ??? ????? ????????? ?
??? ??? ?????? ?????? ??????? ?????? ??? ??? ???
?????).
41???? ?????? ?????? Treatment
- ??? ???? ?????? ?????? ????????? ??????? ????
10-14 ????? ? ???????? ??????? ??????? ??????
????? ??????? ???? ?????? ??????? ??? ????? ?????
??? ??? ?????? ?? ??????? ???? ????? ????? ?????
????? ?????? ??? ???????? ???? ?? 95.
42????? ??????
- ?? ???? ???? ???? ?????? ? ?????? ??? ??? ??????
????? ??? ??? ?? 5 ????? ???? ?????? ?? ??????
??????? ?????? ??????. - ????? ??????? ?? ???? ????? ????? ????? ????
????? ???? ??? ?????? ???? ??? ????? ???????
???????? ?????? ??????? ?????????? ??????? ????
?? ?????? ??????? ????????? ??? ??????? ??
???????.
43???????!
44?? ????? ?????? ????? ???? ??????? ???????
??????? ?????
45(No Transcript)
46(No Transcript)