临床消化病杂志
臨床消化病雜誌
림상소화병잡지
Chinese Journal of Clinical Gastroenterology
2015年
4期
201-203
,共3页
肠化生%内窥镜检查%病理
腸化生%內窺鏡檢查%病理
장화생%내규경검사%병리
intestinal metaplasia%endoscope%pathology
[目的]分析胃黏膜肠化生的临床特征。[方法]对3318例胃镜及病理检查证实的肠化生患者资料进行回顾性分析、总结。[结果]肠化生多发生于50～70岁年龄；男性多于女性；胃内分布：贲门及胃底部占13.3％、胃体大弯侧8.7％、胃体小弯侧27.6％、胃体前壁10.5％、胃体后壁9.1％、胃窦30.8％；轻、中、重度肠化所占比例分别为76.8％、18.0％、5.3％；病理检查肠化生常伴有萎缩及非典型增生，其中单纯肠化病变占32.8％，伴有萎缩的占64.9％，伴有非典型增生的占5.8％；内镜描述常为黏膜发红、糜烂、溃疡、痘疹样隆起，所占比例分别为38.8％、32.3％、12.7％、18.7％。肠化生患者幽门螺杆菌检出率82.67％，高于非肠化生患者（ P＜0.05）；临床症状有不同程度重叠，上腹不适占16.9％、上腹痛18.9％、反酸烧心8.7％、腹胀14.9％、食欲不振13.9％，其他37.4％。[结论]肠化生多发生于中老年人，临床症状无明显特异性，严格的内镜评估以及病理活检对提高肠化生的诊断率尤为重要。
[目的]分析胃黏膜腸化生的臨床特徵。[方法]對3318例胃鏡及病理檢查證實的腸化生患者資料進行迴顧性分析、總結。[結果]腸化生多髮生于50～70歲年齡；男性多于女性；胃內分佈：賁門及胃底部佔13.3％、胃體大彎側8.7％、胃體小彎側27.6％、胃體前壁10.5％、胃體後壁9.1％、胃竇30.8％；輕、中、重度腸化所佔比例分彆為76.8％、18.0％、5.3％；病理檢查腸化生常伴有萎縮及非典型增生，其中單純腸化病變佔32.8％，伴有萎縮的佔64.9％，伴有非典型增生的佔5.8％；內鏡描述常為黏膜髮紅、糜爛、潰瘍、痘疹樣隆起，所佔比例分彆為38.8％、32.3％、12.7％、18.7％。腸化生患者幽門螺桿菌檢齣率82.67％，高于非腸化生患者（ P＜0.05）；臨床癥狀有不同程度重疊，上腹不適佔16.9％、上腹痛18.9％、反痠燒心8.7％、腹脹14.9％、食欲不振13.9％，其他37.4％。[結論]腸化生多髮生于中老年人，臨床癥狀無明顯特異性，嚴格的內鏡評估以及病理活檢對提高腸化生的診斷率尤為重要。
[목적]분석위점막장화생적림상특정。[방법]대3318례위경급병리검사증실적장화생환자자료진행회고성분석、총결。[결과]장화생다발생우50～70세년령；남성다우녀성；위내분포：분문급위저부점13.3％、위체대만측8.7％、위체소만측27.6％、위체전벽10.5％、위체후벽9.1％、위두30.8％；경、중、중도장화소점비례분별위76.8％、18.0％、5.3％；병리검사장화생상반유위축급비전형증생，기중단순장화병변점32.8％，반유위축적점64.9％，반유비전형증생적점5.8％；내경묘술상위점막발홍、미란、궤양、두진양륭기，소점비례분별위38.8％、32.3％、12.7％、18.7％。장화생환자유문라간균검출솔82.67％，고우비장화생환자（ P＜0.05）；림상증상유불동정도중첩，상복불괄점16.9％、상복통18.9％、반산소심8.7％、복창14.9％、식욕불진13.9％，기타37.4％。[결론]장화생다발생우중노년인，림상증상무명현특이성，엄격적내경평고이급병리활검대제고장화생적진단솔우위중요。
Objective]To investigate the clinical characteristics of gastric intestinal metaplasia (IM ). [Methods]Data of patients who were diagnosed as having gastric intestinal metaplasia by gastroscopy and pathological examination were retrospectively analyzed. [Results ]IM was commonly present in patients with 50-70 years old.In the investigation ,13.3% IM located in cardia and fundus ,8.7% in greater curva‐ture of gastric body and ,27.6% in the lesser curvature of gastric body ,10.5% in the anterior wall of the gastric body ,9.1% in the posterior wall of gastric body ,30.8% in the antrum. The proportion of mild , moderate or severe IM was 76.8% ,18.0% ,5.3% respectively.IM was commonly accompanied by Atrophy and atypical hyperplasia. Pathological examination showed 32.8% was IM alone ,64.9% accompanied by Atrophy and 5.8% accompanied by atypical hyperplasia.Endoscopy showed as mucosal redness ,erosion , ulcers ,smallpox‐like uplift and the proportion was 38.8% ,32.3% ,12.7% ,18.7% ,respectively . Helico‐bacter pylori positive rate in patients with IM (82.67% )was higher than patients without‐IM (P<0.05) . The clinical manifestations overlapped in different patients ,including abdominal discomfort 16.9% ,upper abdominal pain 18.9% ,acid reflux 8.7% ,abdominal distension 14.9% ,anepithymia 13.9% ,others 37.4% .[Conclusion]IM is most frenquently present in the middle‐age or old patients without special chini‐cal manifestation. The careful endoscopic assessment and biopsy is particularly important to improve the diagnostic rate.
