胃粘膜肠化类型与慢性胃炎的研究

A Study of the Relationship Between the Different Types of Intestinal Metaplasia (IM) and Chronic Gastritis (CG)

对139例胃粘膜活检标本中肠化类型与慢性胃炎的关系进行研究,Ⅱb型肠化在伴中度或重度腺体萎缩的慢性胃炎组织中的检出率(40.0%,53.8%)显著地高于伴轻度腺体萎缩的慢性胃炎(5.0%)(P<0.01);在伴轻度炎症或静止期炎症的慢性胃炎中,Ⅱb型肠化的检出率(53.5%、59.5%)显著地高于Ⅰa(13.8%、12.3%),Ⅰb(8.6%、7.0%)和Ⅱa型肠化(24.1%、21.1%)(P<0.01).同时伴有Ⅱb型肠化和异型增生的组织,均为中度或重度腺体萎缩者(70.8%).结果表明Ⅰa,Ⅰb型肠化与慢性胃炎重度及活动期炎症有关,可能是对早期炎症刺激的一种反应性变化;Ⅱb型肠化主要与中、重度腺体萎缩有关.在重度体萎缩、Ⅱb型肠化的基础上,胃粘膜易发生异型增生.

To explore the relationship between the different types of IM and CG, 139 specimens of the CG with IM were investigated. The incidence of type Ⅱb IM was significantly higher in the CG with moderate (40. 0%) or severe gland atrophy (53. 8%) than in the CG with mild gland atrophy (5. 0%) (P<0. 01). In the CG with mild or non-active inflammation, the prevalences of type Ⅱ b IM (53. 5%, 59. 5%) were statistically higher than those of type I a (13. 8%,12. 3%), I b (8. 6%,7. 0%) and ⅡaIM (24.1% ,21. 1%)(P<0. 01). The CG with both type Ⅱb IM and dysplasia was only observed in the specimens of the CG with moderate (29.2%) or severe gland atrophy (70.8%). These findings suggest that type I a, I b and Ⅱa IM were mainly related to the presence of severe and active inflammation in CG, and may be the reac-tive changes for early inflammation, but type Ⅱb IM was particularly related to mod-erate and severe gland atrophy of CG, and the CG. With severe gland atrophy and type Ⅱb IM progress easily to dysplasia.