CAJ | 학술논문

目的探讨非幽门螺杆菌感染患者上腹部不适相关症状的可能机制.方法收集2006年8月至11月初次行胃镜、组织学检查幽门螺杆菌呈阴性的成人患者232例,2005年9月至2009年8月门诊及住院儿童患者31例(年龄<14岁).对以上患者行胃镜取胃黏膜组织做连续切片,HE染色及WS染色观察组织学改变.结果成人组患者组织内可观察到微、小动脉腔堵塞和(或)灶性出血病变,其中16例(8.8%)黏膜和(或)黏膜下层见微、小动脉腔部分或完全堵塞,82例(45.6%)仅有黏膜灶性出血,82例(45.6%)两种病变同时存在.微、小动脉腔堵塞病变以移行部检出率最高(65.2%,P=0.159),灶性出血病变以底体部检出率最高(65.6%,P=0.001).微、小动脉腔堵塞病变组烧心症状发生率显著低于无动脉腔堵塞/出血病变组(x2=8.564,P=0.003).儿童组中96.8%(30/31)的患者活检组织中观察到微、小动脉腔堵塞和(或)灶性出血病变.结论胃微、小动脉堵塞引起的黏膜缺血比较常见,可发生于各个年龄段,可能是导致非幽门螺杆菌感染患者上腹部不适相关症状的重要原因.
목적 탐토비유문라간균감염환자상복부불괄상관증상적가능궤제.방법 수집2006년8월지11월초차행위경、조직학검사유문라간균정음성적성인환자232례,2005년9월지2009년8월문진급주원인동환자31례(년령<14세).대이상환자행위경취위점막조직주련속절편,HE염색급WS염색관찰조직학개변.결과 성인조환자조직내가관찰도미、소동맥강도새화(혹)조성출혈병변,기중16례(8.8%)점막화(혹)점막하층견미、소동맥강부분혹완전도새,82례(45.6%)부유점막조성출혈,82례(45.6%)량충병변동시존재.미、소동맥강도새병변이이행부검출솔최고(65.2%,P=0.159),조성출혈병변이저체부검출솔최고(65.6%,P=0.001).미、소동맥강도새병변조소심증상발생솔현저저우무동맥강도새/출혈병변조(x2=8.564,P=0.003).인동조중96.8%(30/31)적환자활검조직중관찰도미、소동맥강도새화(혹)조성출혈병변.결론 위미、소동맥도새인기적점막결혈비교상견,가발생우각개년령단,가능시도치비유문라간균감염환자상복부불괄상관증상적중요원인.
Objective To investigate the potential mechanism for symptoms related to epigastric discomfort in patients without Helicobacter pylori (H.pylori) infection.Methods Patients who underwent gastric endoscopy and conformed H.pylori negative by histologic examination were enrolled.Among them,232 adult patients were collected between August 2006 and November 2006 and 31 children were collected between September 2005 and August 2009.All patients showed no apparent abnormality by endoscopic examination.The endoscopic biopsy was examined with HE or Warthin-Starry staining.Results In adult group,arteriole obstruction was found in 16 (8.8%) cases and focal haemorrhage in 82 (45.6%) cases.Both were existed in 82 (45.6%) cases.The histopathologic findings showed that arteriole obstruction in transition zone (65.2 %,P = 0.159) was common,whereas the focal haemorrhage in gastric fundus and corpus (65.6%,P=0.001) was in predominance.The symptom of heartburn was less in patients with arteriole obstruction and/or focal haemorrhage in comparison with those without these changes (x2 =8.564,P=0.003).In adolescent group,arteriole obstruction and/or focal haemorrhage accounted for 96.8% (30/31).Conclusion Gastric mucosa ischemic resulted from arteriole obstruction are commonly seen in both adult and adolescent patients,which is an important reason for epigastric discomfort in H.pylori negative patients.