慢性萎缩性胃炎胃窦病理与内镜表现对照研究

目的探讨慢性萎缩性胃炎（CAG）病理学指标与内镜表现的关系。方法对46例CAG患者胃窦黏膜病理结果与内镜下各种表现、幽门螺杆菌（Hp）感染情况进行对照比较分析。结果发现46例CAG患者萎缩均伴不同程度的慢性炎症，其中萎缩伴肠上皮化生32例（69．57％），萎缩伴肠上皮化生和上皮内瘤变10例（21．74％），与之对应镜下表现形式多种。胃镜下单红相为主（花斑样改变）表现与病理学诊断萎缩符合率60．87％（28／46），且以轻中度萎缩为主。传统胃镜下萎缩表现与病理诊断萎缩的符合率为21．74％（10／46），其中白相为主，血管透见或显露与病理学诊断萎缩符合率13．04％（6／46），两种及以上胃镜下的表现共存时符合率则更低。结论用传统胃镜下萎缩的表现诊断CAG不可靠，应多作黏膜活检病理才能正确诊断。

Control study on pathologic and endoscopic characteristics of chronic atrophic gastritis for sinus ventriculi

Objective To investigate the relationship between the pathology index and endoscopic characteristics of chronic atrophic gastritis （CAG）. Methods The clinical data of 46 CAG patients, who received sinus ventriculi the examinations of pathologic, endoscopic and infection of Helicobacter pylori （Hp）, were collected and analyzed statistically. Results All patients accompanied with chronic inflammation of different levels, 32 CAG patients accompanied with intestinal metaplasia （69.57%）, and 10 CAG patients accompanied with intestinal metaplasia and intraepithelial neoplasias （21.74%） , while corresponding endoscopic characteristics were multiply. The coincidence rates between endoscopic red characteristics and pathologic diagnosis were 60.87%, mainly of light and moderate degree. The coincidence rates between traditional endoscopic and pathologic diagnosis were 21.74% , mainly of white characteristics, while the coincidence rates between endoscopic revealed blood vessel and pathologic diagnosis were 13.04% , and the coincidence rates were more lower coexisting two and more endoscopic characteristics. Conclusions The method of traditional endoscopic diagnosis of CAG is unreliable. More pathologic examination of mucosa biopsy shall be used to improve the diagnosis rate of CAG.