CAJ | 학술논문

目的探讨慢性萎缩性胃炎胃镜下不同病理改变与幽门螺杆菌(Hp)感染的关系.方法对1623例行胃镜检查后诊断为慢性萎缩性胃炎患者的胃镜形态表现与Hp感染及病理结果进行回顾性分析,探讨不同胃镜表现患者Hp感染的差异及病理表现.结果胃镜下诊断为慢性萎缩性胃炎482例,其中A组239例(胃镜表现黏膜红白相间以白为主,皱襞变平甚至消失,血管显露),B组243例(胃镜表现黏膜呈颗粒状或结节状).A组患者病理诊断为萎缩性胃炎173例,诊断符合率为72.4%(173/239);B组患者病理诊断为萎缩性胃炎206例,诊断符合率为84.8%(206/243),两组诊断符合率比较差异有统计学意义(P<0.05).A组患者病理结果肠上皮化生24例(10.0%,24/239),不典型增生25例(10.5%,25/239);B组患者病理结果肠上皮化生45例(18.5%,45/243),不典型增生57例(23.5%,57/243).两组肠上皮化生与不典型增生的发生率比较差异有统计学意义(P<0.05).A组患者Hp感染138例,感染率为57.7%(138/239),B组患者Hp感染177例,感染率为72.8%(177/243),两组Hp感染率比较差异有统计学意义(P<0.05).结论内镜下以黏膜呈颗粒状或结节状为主要表现的慢性萎缩性胃炎合并肠化生、不典型增生及Hp感染率较高,临床上更应该重视其诊断、治疗和随访.
목적 탐토만성위축성위염위경하불동병리개변여유문라간균(Hp)감염적관계.방법 대1623례행위경검사후진단위만성위축성위염환자적위경형태표현여Hp감염급병리결과진행회고성분석,탐토불동위경표현환자Hp감염적차이급병리표현.결과 위경하진단위만성위축성위염482례,기중A조239례(위경표현점막홍백상간이백위주,추벽변평심지소실,혈관현로),B조243례(위경표현점막정과립상혹결절상).A조환자병리진단위위축성위염173례,진단부합솔위72.4%(173/239);B조환자병리진단위위축성위염206례,진단부합솔위84.8%(206/243),량조진단부합솔비교차이유통계학의의(P<0.05).A조환자병리결과장상피화생24례(10.0%,24/239),불전형증생25례(10.5%,25/239);B조환자병리결과장상피화생45례(18.5%,45/243),불전형증생57례(23.5%,57/243).량조장상피화생여불전형증생적발생솔비교차이유통계학의의(P<0.05).A조환자Hp감염138례,감염솔위57.7%(138/239),B조환자Hp감염177례,감염솔위72.8%(177/243),량조Hp감염솔비교차이유통계학의의(P<0.05).결론 내경하이점막정과립상혹결절상위주요표현적만성위축성위염합병장화생、불전형증생급Hp감염솔교고,림상상경응해중시기진단、치료화수방.
Objective To investigate the relationship between different appearance and pathology change under gastroseope in chronic atrophic gastritis and Helicobacter pylori (Hp) infection. Method The performance of endoscopic morphology, Hp infection and pathology results of patients diagnosed as chronic atrophic gastritis by endoscopy were analyzed retrospectively in 1623 cases and the relationship between different gastroscope forms of change in chronic atrophic gastritis and Hp infection were investigated and the pathological diagnosis results were analyzed retrospectively. Results Four hundred and eighty-two eases were diagnosed as chronic atrophic gastritis in 1623 cases. Group A included 239 patients (endoscopic features were red and white to white-based mucosal, or even flattened folds disappeared, mucosal blood revealed), group B included 243 patients (endoscopic features were granular or nodular mucosa). In group A, 173 eases (72.4%) were diagnosed as atrophic gastritis. In group B, 206 eases (84.8%) were diagnosed as atrophic gastritis. The diagnosis accordance rate of the two groups had significant difference (P < 0.05). In group A, 24 cases (10.0%) showed intestinal metaplasia,and 25 cases( 10.5% ) showed atypical hyperplasia.In group B, 45 cases (18.5%) showed intestinal metaplasia ,and 57 cases (23.5%) showed atypical hyperplasia. The occurrence rates of intestinal metaplasia and atypical hyperplasia had significant difference between the two groups (P< 0.05). The Hp infection rate of group A and group B was 57.7% (138/239) and 72.8% (177/243) respectively, and there was significant difference (P <0.05). Conclusions The incidences of intestinal metaplasia, dysplasia and Hp infection in chronic atrophic gastritis with endoscopic mucosal rough as the main manifestation are higher than those in other forms of chronic atrophic gastritis.More attention should be paid to clinical diagnosis, treatment and follow-up.