糜烂性胃炎462例分析

目的探讨糜烂性胃炎(EG)在内镜下的形态、分布及预后.方法对1997年1月～2003年12月经内镜确诊的462例糜烂性胃炎进行分析.结果462例中,男性336例,女性126例,男女之比2.67:1.隆起糜烂型185例,占40.04%;平坦糜烂型277例,占59.96%.胃窦部363例,占总数的78.57%;其中隆起糜烂型173例,占47.66%;平坦糜烂型190例,占52.34%,两型之间差异无显著性(P＞0.05).胃高位99例,占总数的21.43%;其中隆起糜烂型12例,占12.12%;平坦糜烂型87例,占87.88%;胃窦部隆起糜烂型占47.66%(173/363),胃高位隆起糜烂型占12.12%(12/99);隆起糜烂型和平坦糜烂型HP感染率分别为83.78%和27.08%,差异有非常显著性(χ2=142.68,P＜0.01).结论胃窦部与胃高位糜烂性胃炎的发病率均以男性为主,其中隆起糜烂型好发于胃窦部,而胃高位以平坦糜烂型为主.     

莫沙必利联合铝碳酸镁治疗胆汁反流性胃炎疗效观察

目的　探讨铝碳酸镁及莫沙必利对胆汁反流性胃炎的疗效。方法　将 45例经胃镜证实胃液内有胆汁贮留及胃窦明显炎症的胆汁反流性胃炎随机分为A、B、C组。A组 ( 15例 )服用莫沙必利 5mg/次 ,3次 /d ;B组 ( 16例 )服用铝碳酸镁 1.0g/次 ,3次/d ;C组 ( 14例 )同时服用西沙必利和铝碳酸镁 ,剂量同A、B组。治疗 4周后观察上腹痛、腹胀、恶心、呕吐症状变化。结果　治疗后三组患者症状均明显减轻 ( P <0 .0 5或 <0 .0 1) ,C组症状改善更明显 ( P <0 .0 5或 <0 .0 1)。结论　莫沙必利、铝碳酸镁联合应用治疗肝胆汁反流性胃炎的疗效优于单一用药     

Helicobacter pylori infection and gastric emptying of solids in humans

Helicobacter pylori has been implicated in a number of upper gastrointestinal illnesses. In a controlled study, we have investigated the relationship between H. pylori infection and gastric emptying of solids in two groups of patients with chronic symptoms of dyspepsia. In the first group, 19 patients with non-ulcer dyspepsia and H. pylori infection underwent a standard test of gastric emptying after ingestion of 500 μCi of Tc-labelled chicken liver. The results were compared to a control group of 16 uninfected volunteers. We also studied a second group of 20 patients with previously diagnosed idiopathic gastroparesis for the prevalence of H. pylori infection and its relationship to symptom severity and rates of gastric emptying. In the first group of patients, the half-time of gastric emptying was significantly less among the infected patients compared to the uninfected volunteers (108 ± 9 vs. 142 ± 14 min, P < 0.05). In the second group of patients with gastroparesis, the prevalence of H. pylori was not significantly different among these patients than among 21 age and sex matched controls (20% vs. 38%, P = 0.32). Gastric emptying was markedly slow in all 20 patients in the second group but less so among the four with H. pylori infection. Symptom scores were no different between infected and uninfected patients. We conclude that H. pylori infection is not associated with abnormally slow gastric emptying. On the contrary, gastric H. pylori infection appears to be associated with mildly accelerated emptying of solids compared to normal controls. Idiopathic gastroparesis and dyspepsia related H. pylori infection are separate but sometimes overlapping disorders.     

氟中毒和氟砷中毒对胃粘膜的影响

作者通过内窥镜对新疆奎屯地区氟中毒患者３５名，氟砷中毒患者３２名，对照组２５名的胃粘膜进行观察，旨在了解氟元素和砷元素对胃粘膜的影响，在３个组中慢性胃炎的炎症程度与炎症活动性有显著性差异。２个中毒组间无显著性差异。结果表明在高氟区和高氟砷区患者的胃粘膜层病理改变主要是任性氟中毒引起，单纯性砷中毒并无协同作用。     

胶态果胶铋对实验性大鼠急性胃炎及兔慢性胃炎疗效的观察

果胶铋是一种新型的铋制剂，实验发现：０．５ｇ／ｋｇ／ｄ果胶铋灌胃大鼠能够明显减轻由ＨＣＩ引起的急性胃炎胃粘膜的病变程度；同时还发现，０．２５／ｋｇ／ｄ果胶铋灌胃家兔对兔实验性变态反应性胃炎有明显的治疗作用，能显著减小病变面积，减轻或消除胃粘膜炎症，且未见溃疡发生。其疗效与得乐疗效相比无显著性差异。     

热盐水致大鼠萎缩性胃炎胃粘膜组织细胞增殖与凋亡的实验研究

目的　研究热盐水灌胃导致的大鼠萎缩性胃炎胃粘膜组织中的凋亡细胞及增殖细胞表达状态 ,以探讨长期热咸饮食与慢性萎缩性胃炎发生的关系。方法　采用脱氧核糖核酸转移酶介导的缺口末端标记 (TUNEL)技术及免疫组织化学染色技术。细胞凋亡时DNA含量分析采用流式细胞检测技术。结果　①TUNEL检测细胞凋亡显示 :在热盐水所致的大鼠萎缩性胃炎中凋亡细胞数明显增多 ,在粘膜全层均可见到 ,呈弥漫性分布。萎缩性胃炎中凋亡细胞指数显著高于正常大鼠胃粘膜 (P <0 .0 5) ;②免疫组化法检测显示 :增殖细胞核抗原 (PCNA)在热盐水灌胃所致的萎缩性胃炎中的表达率显著高于正常胃粘膜 (P <0 .0 5) ;③流式细胞检测显示 :萎缩性胃炎时 ,在G0 /G1峰前可见一个亚G0 /G1峰 ,也即凋亡细胞峰出现 ,而在正常胃粘膜时未显示亚G0 /G1峰。结论　热盐水灌胃可导致大鼠胃粘膜组织细胞增殖和细胞凋亡异常 ,其在热盐水所致的大鼠萎缩性胃炎发生中起重要作用。     

胃窦粘膜生长抑素含量与胃、十二指肠疾病的关系

应用放射免疫方法测定１６６例接受胃镜检查者的胃窦部粘膜的生长抑素（ＳＳ）含量，比较几种胃、十二指肠疾病患者与正常人的差异，并探讨胃窦粘膜ＳＳ含量与胃窦部病理改变及幽门螺杆菌（ＨＰ）感染之间的关系。结果显示：胃溃疡、慢性萎缩性胃炎、胃癌患者胃窦部粘膜ＳＳ含量明显低于正常对照组；胃窦部粘膜出现肠上皮化生和不典型增生改变者ＳＳ含量明显低于不伴这些改变者；ＳＳ含量与ＨＰ感染关系不明显。     

INVASIVE MUCORMYCOSIS WITH GASTRIC INVOLVEMENT IN A PATIENT WITH SEVERE ATHEROMATOUS VASCULAR DISEASE

Gastric mucormycosis involvement is a rare condition that usually occurs in inmunocompromised patients and frequently has a fatal outcome. We report the case of a 73‐year‐old woman admitted to the intensive care unit with severe bleeding after an acute pulmonary disease. Upper endoscopy disclosed wide and deep necrotic ulcers in the body and fundus of the stomach and greenish exudates with the antrum and the duodenum undamaged. Autopsy revealed an invasive mucormycosis and a severe atheromatosis. Several predisposing factors for mucormycosis infection have been reported until now. We postulate that ischemic gastritis could be a predisposing factor for colonization of zygomycete.     

在非溃疡性消化不良中ELISA法测抗幽门螺旋杆菌抗体的临床意义

非溃疡性消化不良(NUD, non-ulcer dyspepsia)是常见症候群,其病因尚未完全明了。NUD中幽门螺旋杆菌(HP Helicobacter Pylori)相关性胃炎占很大比例。针对该菌产生之抗体反应,应用酶联免疫法(ILISA)检测了335例NUD患者血清抗-HP抗体。其中208例为经细菌培养及(或)组织学检查证实的HP相关性胃炎,对其中164例进行前瞻性随机安慰剂对照研究,以评价胶态次枸橡酸铋加氟哌酸治疗效果.治疗组与安慰剂组HP清除率分别为69％与6％(P<0.01)。HP清除后患者胃粘膜炎症好转或消除,症状明显减轻,抗-HP抗体滴度下降。     

非溃疡性消化不良的幽门螺杆菌研究

本研究旨在观察幽门螺杆菌（ＨＰ）在非溃疡性消化不良（ＮＵＤ）发病中的作用。结果显示，ＮＵＤ患者ＨＰ阳性率为８３．６％，ＨＰ感染率显著高于健康人（Ｐ＜０．０１）。提示幽门螺杆菌在非溃疡性消化不良发病机制中可能有重要意义。