126例慢性胃炎胃镜下表现与病理诊断对照

目的研究慢性胃炎胃镜下表现与病理诊断的符合率并提出相应措施。方法确诊的慢性胃炎病例共计126例进行回顾性分析。所有患者均进行了胃镜和病理学检查。结果 26例胃镜诊断为慢性浅表性胃炎的患者病理诊断为慢性萎缩性胃炎,胃镜诊断为特殊类型胃炎的患者病理诊断均为慢性浅表性胃炎。以病理学最终诊断结果为准,慢性浅表性胃炎肠化的患者占17.9%,慢性萎缩性胃炎肠化的患者占43.8%。差异具有统计学意义(P<0.05)。从Hp的检出率来看,慢性浅表性胃炎肠化的患者占34.6%,慢性萎缩性胃炎肠化的患者占41.7%。差异具有统计学意义(P<0.05)。结论对慢性胃炎患者在胃镜检查的基础上须进行病理学检查以明确诊断。     

慢性胃炎的自我康复

慢性胃炎分为慢性浅表性胃炎、慢性糜烂性胃炎、慢性萎缩性胃炎、慢性胆汁返流性胃炎、慢性疣状胃炎、药物性胃炎、乙醇性胃炎等。而慢性浅表性胃炎约占慢性胃炎的80%,它是一种慢性胃粘膜浅表性炎症,好发年龄为31～50岁。临床上,大部分慢性浅表性胃炎患者无症状或症状比较轻微,可有不同程度的消化不良,进食后上腹不适等。部分患者可有上腹隐痛症状,多与饮食有关,空腹时比较舒服,进食后会感到不适。常因进食冷、硬或辛辣等刺激食物而诱发疼痛,也可因寒冷或情绪不佳而加重症状。     

慢性萎缩性胃炎的胃镜下表现与病理诊断对照分析

目的:对照分析慢性萎缩性胃炎的胃镜下表现与病理诊断效果情况.方法:选取80例慢性萎缩性胃炎病例作为研究对象,针对所有的患者实施胃镜和病理学方法进行检查,对于胃镜检查下表现以及符合率展开分析及探究.结果:胃镜诊断检查的结果为:55例病例显示为慢性萎缩性胃炎,同时在患者中具有25例病例属于慢性萎缩性胃炎合并浅表性胃炎;具有65例患者经过病理诊断结果表明属于慢性萎缩性胃炎,在患者中涵盖了9例病患为慢性萎缩性胃炎合并浅表性胃炎情况,6例病患属于浅表性胃炎.经过比较胃镜下表现和病理诊断情况,获得到了84.62%的诊断符合率.结论:对于慢性萎缩性胃炎实施胃镜诊断和病理诊断之间具有差距性特点,所以在进行确诊期间应该联合两种手段,将确诊率显著提升.     

慢性萎缩性胃炎临床诊疗体会

目的:探讨慢性萎缩性胃炎的发病因素、临床特征及治疗措施。方法:回顾性分析46例慢性萎缩性胃炎患者的临床资料,总结治疗措施。结果:通过治疗46例慢性萎缩性胃炎治愈10例,好转32例,无效4例,总有效率91.3%。结果:慢性萎缩性胃炎发病因素较多,根据不同的发病因素采取合适的治疗方法,可以取得较好的临床疗效。     

慢性萎缩性胃炎危险因素病例对照研究

目的探讨慢性萎缩性胃炎危险因素,为疾病防治提供科学依据。方法以1∶1配对病例对照研究方法,对148例慢性萎缩性胃炎病例和148例健康对照者进行问卷调查。用卡方检验、单因素和多因素条件logistic回归法进行分析。结果烧烤(OR=7.00)、吸烟(OR=3.18)、口味偏咸(OR=2.38)、家族慢性胃病史(OR=2.22)和饮酒(OR=2.14)是慢性萎缩性胃炎的危险因素,而经常吃水果(OR=0.33)、新鲜蔬菜(OR=0.35)、奶制品(OR=0.42)和个性温和(OR=0.49)是保护因素。结论家族慢性胃病史、饮食生活习惯及精神心理因素等对慢性萎缩性胃炎发病有影响。     

胃癌家族史与饮食和情绪间交互作用对慢性萎缩性胃炎的影响研究

目的 探讨胃癌家族史与饮食和情绪之间交互作用对慢性萎缩性胃炎的影响。方法 选取2015—2018年哈尔滨市某医院907例慢性萎缩性胃炎患者为病例组,同期913名健康体检者为对照组,采用多因子降维、叉生分析和相加模型分析胃癌家族史与饮食和情绪之间交互作用对慢性萎缩性胃炎的影响。结果 同时伴有腌晒食品、水果、精神压抑、胃癌家族史的人群发生慢性萎缩性胃炎的风险增加3.448倍。胃癌家族史与精神压抑、腌晒食品、水果联合作用的OR值分别为11.626、6.256、2.096。胃癌家族史与水果可能存在负相加交互作用,OR值为0.146。结论 胃癌家族史与水果、腌晒食品、精神压抑具有交互作用,水果、胃癌家族史对慢性萎缩性胃炎可能存在拮抗作用。     

萎缩性胃炎与肠上皮化生研究的进展

慢性萎缩性胃炎与肠上皮化生(简称肠化)常同时存在,且发病颇为普遍,其病因、发病机制迄今尚未完全阐明。但因其与胃癌关系密切,多数学者将其作为胃癌癌前病变,故引起广泛重视。因此,对萎缩性胃炎与肠化的发病和防治的研究,对预防和减少胃癌的发病率具有重要意义。一、萎缩性胃炎病因与病理的研究:萎缩性胃炎的病因迄今不太明了,以往认为与自身免疫而产生的壁细胞抗体有关。但近年来以电镜作超微结构研究,发现不论萎缩性胃炎伴血清壁细胞抗体阳性或阴性患者,二者的超微结构均无显著差异,提示壁细胞抗体是胃粘膜损害的一种继发现象,而不是壁细胞损害的原因。亦有报告我国萎缩性胃炎壁细胞抗体低于     

慢性萎缩性胃炎患者血清中MG7-Ag、PG表达水平及其临床意义

慢性萎缩性胃炎是最常见的一种慢性消化系统疾病,与饮食、免疫、幽门螺杆菌感染等因素有关,属于多因素引起的疾病[1]。目前,随着经济的发展,人们生活水平、生活方式等改变,慢性萎缩性胃炎的发生呈现出上升的趋势,严重影响人们的正常生活[2]。因此,探讨慢性萎缩性胃炎患者血清中胃癌抗原(MG7-Ag)、胃蛋白酶原(PG)表达水平及其临床价值,应用Spearman分析法分析慢性萎缩性胃炎患者萎缩严重程度与PGⅠ、PGⅡ和MG7-Ag、PGR表     

慢性萎缩性胃炎患者的危险因素与临床治疗效果

目的探讨发生慢性萎缩性胃炎患者危险因素,并对比不同方案治疗幽门螺杆菌阳性患者的临床效果,为临床诊治提供参考。方法选取2010年3月-2014年4月90例慢性萎缩性胃炎患者,列为萎缩组,选取同期94例慢性非萎缩性胃炎患者,列为非萎缩组,对比两组患者临床资料分析危险因素;将萎缩组50例Hp阳性患者随机分为观察组与对照组,每组各25例,进行不同治疗方案,对比分析两组患者治疗效果。结果年龄、胆汁反流、胃癌家族史、Hp感染是慢性萎缩性胃炎危险因素;慢性萎缩性胃炎患者中观察组治疗有效率92.00%、对照组为80.00%,两组对比差异有统计学意义(P<0.05)。结论高龄、家族胃癌史、胆汁反流是慢性萎缩性胃炎危险因素,以叶酸为主的联合治疗方案治疗慢性萎缩性胃炎患者Hp阳性效果好。     

患了慢性萎缩性胃炎不要慌

慢性胃炎是消化内科门诊的常见疾病,患病率较高,一般可分为慢性非萎缩性胃炎和慢性萎缩性胃炎,而慢性萎缩性胃炎常与胃癌联系到一起.那么,什么是慢性萎缩性胃炎?得了慢性萎缩性胃炎是不是一定会得胃癌?慢性萎缩性胃炎应如何治疗?日常饮食应注意些什么?     

胃镜结合病理分析在慢性萎缩性胃炎诊断中的意义

[目的]探讨胃镜结合病理分析在慢性萎缩性胃炎诊断中的意义。[方法]对70例CAG的胃镜下表现与病理诊断进行相关性分析,分别计算胃镜下各种表现对病理诊断CAG的敏感性和特异性。[结果]70例患者胃镜直视下诊断为CAG者70例,病理诊断为CAG者58例,其中伴肠上皮化生26例,异型增生11例。慢性浅表性胃炎(CSG)12例,总体而言,CAG胃镜与病理诊断符合率为82.86%。胃镜下CAG的表现特征主要有3点:A黏膜变薄、皱襞变平;B:血管显露,红白相间以白为主;C:黏膜粗糙不平,呈颗粒状或结节样改变,对于黏膜萎缩而言,其阳性预测值:A+B≥70%,A+B+C=96.77%,差异显著(P﹤0.05);对肠上皮化生而言,A+B的阳性预测值仅为16.00%,异型增生中诊断中,C的阳性率在28.57%。Hp检查结果其中阳性者43例,占61.42%,阴性者27例,占38.58%,其中Hp感染阳性患者与胃黏膜的3种病理改变有关,三者比较,黏膜萎缩与肠化、异型增生之间差异均有统计学意义(P﹤0.01)。[结论]慢性萎缩性胃炎胃镜和病理诊断有一定相关性,胃镜和病理检查的紧密结合有利于慢性萎缩性胃炎的正确诊断。     

福建省胃癌中高发地区居民健康和饮食调查研究

[目的]比较福建省胃癌高发区(长乐)和中发区(同安)居民健康状况及饮食习惯,探索胃癌高发的可能原因,为防制工作提供依据。[方法]以随机抽样法抽取两地5年及以上常住居民一对一问卷调查,并进行统计分析。[结果]长乐居民慢性胃炎史、消化性溃疡史、家族胃癌史和自觉消化系统症状均高于同安居民。长乐居民饮食习惯中不良甚至有害因素较同安多,如食用鱼露制品、酸菜、烫食和陈旧粮食等。同安居民饮食习惯中的保护因素较长乐多,如摄入新鲜蔬菜水果和饮茶等。[结论]胃癌高、中发区居民在健康状况和饮食习惯等方面存在较大的差异,有必要在胃癌高发区开展健康教育,促进居民关注自身健康,改变不良或有害的饮食习惯。     

上海松江岳阳社区居民慢性病患病现状及行为危险因素分析

[目的]了解上海市松江区岳阳社区居民慢性非传染性疾病的流行现状及行为危险因素。[方法]采用分层随机抽样的方法，按国家卫生部“中国成人慢性病危险因素调查”的要求，抽取在该社区居住满1年的18～69岁常住居民1984名，进行问卷调查和体格检查。[结果]72．1％的样本人群具有≥1种危险因素，33．1％的样本人群患有≥1种慢性病。吸烟率、饮酒率、超重率、肥胖率分别为24．1％、21．5％、27．5％、6．6％；样本人群中，34．7％缺乏体力活动，49．1％钙质摄入不足，6．9％维生素B、C摄入不足，45．3％蛋白质摄入不足，9．7％嗜腌制品（苯丙胺类致癌物质及高钠食品）；高血压和糖尿病的患病率分别为26．6％、5．5％。Logistic回归分析显示：高血压、糖尿病的共同危险因素为40岁以上人群、高血脂、肥胖。[结论]行为危险因素的持续存在，已导致慢性病的高发。大力开展社区健康教育与健康促进，应采取综合性干预措施，遏止慢性病流行。     

慢性萎缩性胃炎胃镜下不同病理改变及幽门螺杆菌感染情况研究

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.

Abstract：

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.     

肝硬化门脉高压性胃病与幽门螺杆菌感染关系探讨

目的探讨幽门螺杆菌（HP）在肝硬化门脉高压性胃病发生、发展中的作用及临床意义,观察HP感染与食管静脉曲张程度的关系。方法随机选取新乡市中心医院肝硬化门脉高压性胃病患者76例及同期在同医院经胃镜和组织学检查确诊为无肝病病史中的慢性胃炎和消化性溃疡患者87例,进行分析。结果肝硬化门脉高压组HP感染率为30.3%,显著低于慢性胃炎组的76.5%（P〈0.05）和消化性溃疡组的83.3%（P〈0.05）。门脉高压性胃病患者慢性活动性胃炎HP感染率为53.6%,非活动性胃炎HP感染率为16.7%,两者差异有统计学意义（P〈0.05）。HP感染率随食管静脉曲张程度的增加而下降（无食管静脉曲张者HP阳性率为58.3%,有食管静脉曲张者HP阳性率为21.2%,P〈0.05。）结论肝硬化门脉高压性胃病是一种独特类型的胃病,其发生与发展与HP感染无显著相关性;HP感染不是门脉高压性胃病的主要致病因素,但HP感染和门脉高压性胃胃病黏膜的慢性活动性胃炎密切相关;肝硬化门脉高压影响HP感染率。     

Chronic atrophic gastritis and Helicobacter pylori infection among Japanese Americans in Seattle

Gastric cancer is still a major cause of mortality due to cancer worldwide. The most common type of gastric cancer is intestinal type carcinoma, which usually occurs in stomachs containing chronic atrophic gastritis. Individuals with chronic atrophic gastritis are considered to be at increased risk for developing intestinal type carcinoma of the stomach. To examine the association between chronic atrophic gastritis and other gastric cancer risk factors, a cross-sectional study was conducted using serum samples and questionnaire information collected from 776 persons of full Japanese ancestry in the greater Seattle area in 1994. The presence of chronic atrophic gastritis and Helicobacter pylori infection was determined by measurement of serum pepsinogen levels and H. pylori antibodies, respectively. Based on multiple logistic regression, the significant predictors of chronic atrophic gastritis were age over 50 years, H. pylori infection, and 20 years or more lived in Japan. Alcohol consumption, smoking, prior peptic ulcer, and history of gastric cancer in parents were not significantly associated with chronic atrophic gastritis. The results imply that H. pylori infection since earlier life and other unknown exposure factors in Japan might have played an important role in the development of chronic atrophic gastritis.     

研究ITF、CD34在胃黏膜病变中的表达及其临床意义

[目的]探讨肠三叶因子（ITF）在胃黏膜病变中的表达与间质微血管（MVD）值的关系。[方法]利用组织芯片技术制作302例不同胃黏膜（正常胃黏膜A、浅表性胃炎B、萎缩性胃炎C、不典型增生D和胃癌E）的组织芯片,同时用S-P免疫组化方法检测ITF和CD34表达,用CD34标记血管内皮细胞并计算MVD值。[结果]C、D和E胃黏膜ITF表达的阳性率,均高于B和A;E的MVD高于A、B、C和D;B的MVD高于A,C的MVD高于B;在胃癌中ITF阳性表达的MVD高于阴性,ITF表达的阳性率与MVD呈正相关（r=0.323,P〈0.01）。ITF表达的阳性率与胃癌组织类型、淋巴结转移和TNM分期有关,MVD与胃癌浸润深度、淋巴结转移和TNM分期有关。[结论]ITF可能参与胃黏膜保护及修复,在胃黏膜癌变过程中,ITF和CD34表达的阳性率逐渐上调,对胃癌发生发展、浸润转移和血管形成有促进作用,可作为胃癌的早期诊断和预测转移的重要指标。     

Gastric mucosal Helicobacter pylori distribution and its implications

In tile present study the clinicopathological aspects of H. pylori infection in different parts of the stomach were investigated in 36 patients. The results showed that 28 patients (77.8%) were H. pylori positive and 8 patients (22.2%) were H. pylori negative by histopathology and confirmation with modified Giemsa stain. There was no statistically significant difference belween H. pylori positive and negative patients regarding dyspeptic symptoms or intestinal metaplasia histopathologically. Histopathological examination revealed chronic gastritis with mononuclear cell infiltration in all studied patients. According to the degree of cell infiltration, chronic gastritis was graded as mild, moderate and severe. There was a statistically significant difference between H. pylori positive and H. pylori negative patients regarding both severity and activity of chronic gastritis in the antrum and body compared to the fundus. Also, there was significant correlation between the grade of H. pylori colonization and the grade of chronic active gastritis on one hand and between H. pylori infection and atrophic gastritis. The serum anti-H. Pylori - IgG positive cases who were H pylori negative by history, showed atrophic gastritis acid intestinal metaplasia. This may be due to the fact that the mucosa has become inhospitable for H. pylori.     

A study of Helicobacter pylori infection in patients with pernicious anemia

INTRODUCTION: Chronic atrophic gastritis presents with atrophy of the gastric mucosa, hypochlorhydria or achlorhydria and unstable gastrin level. Type A chronic atrophic gastritis associated with hypergastrinemia is regarded as the principle causative factor for pernicious anemia. AIM: The study aimed at evaluation of the incidence of H. pylori infection in patients with pernicious anemia and analyze its relation to the severity of gastritis. MATERIAL AND METHODS: Forty patients with pernicious anemia (group 1) were examined for presence of H. pylori infection. Sex- and age-matched patients with gastric ulcer (group 2) and chronic superficial gastritis (group 3) were used as controls. Three antral forceps biopsies were obtained from all patients during videogastroscopy. The presence of H. pylori was verified by urease test, histological and microbiological examination. RESULTS: All patients with pernicious anemia had chronic atrophic gastritis and several times lower incidence of H. pylori infection than the patients with gastric ulcer. Chronic atrophic gastritis was not diagnosed in group 3 patients. Statistically significant difference in Helicobacter pylori infection was found between groups 1 and 2 (P < 0.001) but not between groups 1 and 3 (P > 0.05). CONCLUSIONS: Atrophic gastritis was diagnosed in all patients with pernicious anemia. These patients showed significantly lower incidence of H. pylori infection than the gastric ulcer patients. The patients with pernicious anemia had lower gastritis index and quantitatively less expressed infection than the other two groups.     

胃镜下慢性萎缩性胃炎诊断准确性分析

目的合理评估胃镜下慢性萎缩性胃炎诊断的临床参考价值。方法回顾性分析自2012年9月—2013年9月于我院接受胃镜检查的32例患者的临床资料,对照病理诊断结果,分析胃镜检测的符合率。结果 32例患者在胃镜直视下诊断为慢性萎缩性胃炎患者共26例,诊断为慢性浅层胃炎者6例,胃镜检查与病理诊断符合率为81.25%。结论为提高胃镜下慢性萎缩性胃炎的检出率,在提高胃镜分辨率的同时,强化医师对肠胃黏膜形态的精确认识,多角度、多方位观察患者肠胃黏膜形态,必要情况下还需结合病理诊断反复验证。