内镜下胃粘膜皱襞粗大45例分析

目的：明确内镜下胃粘膜皱襞粗大的临床意义，提高对该征象的认识。方法：对1990-2001年北京协和医院内镜检出的胃粘膜皱襞粗大45例患者资料进行回顾性分析，所有病例均行胃粘膜病理学检查，部分病例行超声内镜检查（EUS）和上消化道气钡双重对比造影检查。结果：45例胃粘膜皱襞粗大患者中胃炎30例（66.7％）；胃肿瘤7例（15.6％），其中胃癌5例，淋巴溜2例；巨大胃粘膜肥厚症4例均为Menetrier病（8.9％0；系统性红斑狼疮（SLE）2例（4.4％0；吻合口炎、胃溃疡各1例。除1例胃癌位于胃体胃窦交界处之外，胃亚性病变、巨大胃粘膜肥厚症及SLE均分布在胃底和（或）胃体部，或为全胃病变。结论：分布在胃窦部的1-2条粗大胃粘膜皱襞均为炎性改变，分布在胃底、胃体或全胃的病变更有临床意义。EUS及上消化道造影均有助于病变良恶性的鉴别。

Large gastric folds--analysis of 45 cases

Objective To enrich the knowledge in large gastric folds. Methods We investigated 45 cases of large gastric folds in ten years (1990 - 2001) retrospectively. All cases were examined endo-scopically and histologically. Some of them were examined by endoscopic ultrasonography and upper gastrointestinal barium. Results Of 45 cases with large gastric folds there were 30 cases with gastritis (66. 7% ) , seven with malignant tumors( 15. 6% ) (five with gastric carcinoma and two with malignant lymphoma) , four with Menetrier disease(8. 9% ) , two with systemic lupus erythematosus, one each with Billroth II anastomosis and gastric ulcer. The diseases including tumors, Menetrier disease and connective tissue diseases were located in gastric fundus and/or body . Conclusion The diseases located in upper stomach have more clinical significance. All of endoscopic ultrasonography, upper gastrointestinal barium and endoscopic mucosal resection are helpful in differential diagnosis of the large gastric folds.