摘要
目的探讨原发性胆汁反流性胃炎(BRG)的临床病理特征。方法选取218例BRG患者作为观察组,均经临床及无痛胃镜确诊,选同期进行胃镜检查确诊的单纯慢性胃炎患者236例作为对照,均行胃镜、H.pylori及组织病理学检查,比较两组胃镜下表现、H.pylori感染率、组织形态学特征、慢性炎症的严重度及活动性积分。结果观察组H.pylori感染率为39.0%(85/218),明显低于对照组[52.1%(123/236)]。两组胃镜下所见充血、出血、糜烂及血管透见的检出率均无明显差异(P>0.05)。两组H.pylori阳性者炎症严重度积分及活动度积分均高于H.pylori阴性者(P<0.05)。观察组炎症严重度积分和肠化、萎缩及不典型增生检出率均高于对照组,胃小凹延长、毛细血管扩张、间质水肿也较对照组明显(P<0.05)。结论原发性BRG具有化学性胃炎的部分特征,萎缩、肠化及不典型增生的发生率增高,应重视胃镜组织病理检查。
Objective To analyze the clinical and pathological features of primary bile reflux gastritis（BRG）.Methods Endoscopy,Helicobacter pylori（H.pylori） detection,and histopathologic examination were performed in 218 patients with primary BRG（observed group） and 236 patients with simple chronic gastritis（SCG,control group） as identified by gastroscope in order to analyze the endoscopic abnormalities,the frequency of H.pylori infection,pathological features and scores of inflammation.Results The frequency of H.pylori infection was 39.0%（85/218） in the observed group,which was significantly lower than that in the control group [52.1%（123/236）].The topographic abnormalities of the antral mucosa as detected by gastroscopy,i.e.,congestion,hemorrhagic spots,erosion were not significantly different between BRG and SCG patients（P〉0.05）.The scores of chronic and active inflammation were higher in patients when H.pylori infection was present than in patients without H.pylori infection in both groups（P〈0.05）.The scores of inflammation,the detection rates of the antral intestinal metaplasia,antral atrophy and atypical hyperplasia were all higher in observed group than in control group（P〈0.05）.The incidence of lengthening of gastric pits,telangiectasis or interstitial edema in BRG patients was also significantly higher than those in SCG patients（P〈0.05）.Conclusions Primary BRG shows features of chemical gastritis with a higher tendency toward mucosal atrophy,intestinal metaplasia and atypical hyperplasia.Gastropic examination and biopsy should be emphasized.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2011年第5期498-500,共3页
Medical Journal of Chinese People's Liberation Army
关键词
胃炎
胆汁返流
病理学
临床
胃镜检查
gastritis
bile reflux
pathology, clinical
gastroscopy
