幽门螺杆菌与成人结节性胃炎关系分析.docVIP

幽门螺杆菌与成人结节性胃炎关系分析 　　摘 要 目的：探讨结节性胃炎的临床特点及与幽门螺杆菌（Hp）的关系，以提高对其的认识。方法：观察诊断为结节性胃炎患者的内镜、病理表现，以及Hp感染情况和根除治疗的效果。结果：33例结节性胃炎病例中，内镜下表现特点为：以胃窦部为主，大小均匀的结节样或颗粒样改变。Hp感染率93.9%，病理检查提示胃黏膜呈中度至重度炎症改变，淋巴滤泡发生率69.6%。明显高于其他胃炎。经给予质子泵抑制剂为基础的三联疗法根除治疗后，随着Hp的根除。临床症状消失，淋巴滤泡消失，病理炎症程度减轻。结论：结节性胃炎为Hp感染的一种特殊征象，是慢性胃炎的一种特殊内镜下表现，是Hp感染的内镜指标，提示对结节性胃炎应考虑Hp根除治疗。 　　关键词 结节性胃炎 幽门螺杆菌 根除治疗 　　 　　AbstractObjective To investigate the clinical characteristics of nodular gastritis and the relationship between it and helicobacter pylori（Hp）.In this way,we canimprove the cognition of it.Methods:Endoscopic,pathologic manifestation,infection situation of Hp and eradication effect of 33 nodular gastritis diagnosed by our hospital were analyzed.Results The endoscopic manifestations were size uniform nodular or Particle Like changes mainly located in gastric antrum，rate of Hp infection was 93.9%.There existed moderate or severe inflammation and the incidence of lymphoid follicles in gastric mucosa was 69.6%which was evidently higher than other gastritis.After the patients were cured with triple regimens based on proton pump inhibitor,clinical manifestations disappeared with the eradication of Hp,the degree of pathological inflammation reduced and lymphoid follicles disappeared.Conclusion:Nodular gastritis in adult is a special sign of Hp infection,nodular pathological change is a special endoscopic manifestation of chronic gastritis and is all endoscopic marker of Hp infection.It may suggest that nodular gastritis in children must consider eradication therapy of Hp. 　　Key wordsNodular gastritis;Helicobacter pylori（Hp）;Eradication therapy 　　结节性胃炎是慢性胃炎的一种特殊类型，与幽门螺杆菌（helicobacter pylori，Hp）感染密切相关。据报道，在成人Hp感染与萎缩性胃炎、增生性息肉、恶性贫血、胃癌及肉芽肿性胃炎等有关［1～3］。近几年来，胃镜检??发现了越来越多的结节状胃炎，在临床上常常被误诊为慢性萎缩性胃炎。结节性胃炎好发于儿童，成人较儿童发病率低，关于成人结节性胃炎报道较少，就成人结节性胃炎的临床及病理特点、与Hp的关系，及抗Hp治疗前后加以比较，以提高临床医师对本病认识。 　　 　　资料与方法 　　2005年7月～2009年12月收治结节性胃炎患者33例，男10例，女23例，男女比例1:2.3；年龄18～70岁，平均34.3岁。对照组40例，其中男17例，女23例，年龄22～70岁，平均30.2岁。 　　方法：回顾性分析33例结节状胃炎患者的临床表现、病理结果及Hp