胃窦粗大皱襞的临床表现、内镜形态及组织学改变

Clinical manifestation,morphology under gastroscopy and histological alterations in patients with hypertrophic gastric folds

目的:探讨胃窦部粗大皱襞形成的原因、临床表现、内镜形态及组织学改变.方法:对胃镜检查中发现有胃窦部粗大皱襞患者,询问临床特点、内镜下检查形态、活组织病理检测其组织学改变,^(13)C尿素呼气试验测定其幽门螺杆菌感染率.结果:临床见有进食后上腹饱胀及上腹隐痛,伴有反酸、烧心、嗳气,胃动力药及助消化药物不能改善症状;内镜下形态以纵行条状粗大皱襞多见,弧形、类圆形次之.位于胃窦部小弯侧,1-4条,通向幽门,大部分脱入十二指肠,所有患者均有不同程度的胃炎.病理提示不同程度浅表性胃炎或不典型增生,伴糜烂者不典型增生比例较高.肠上皮化生、腺体数量减少也占一定比例.幽门螺杆菌阳性率为84.98%.结论:在胃窦部粗大皱襞中,幽门螺杆菌感染,不典型增生和肠上皮化生较一般浅表性胃炎高,可能与胃癌的发生有一定关系.

AIM： To explore causative agents, clinical manifestations, morphology under gastroscopy and histological alterations in patients with hypertrophic gastric folds （HGFs）. METHODS： Determining clinic characteristics, recording details of morphology under gastroscopy, detecting histological alterations, and calculating the infection rate of Helicobacter pylori in patients with HGFs. RESULTS： Clinical characteristics were persistent superior abdominal distention or vague pain that was not improved by treatment with prokinetics or dijex. The frequent HGF morphology was longitudinal institia shaped, half-moon and unrepresentative round. In general, there were one to four HGFs that did not disappear after pumping air through the gastroscope in the sinus ventriculi on the lesser curvature side, the most part of which could enter the dodecadactylon and block the duodenal opening of the stomach. All patients had gastritis, some accompanied with a duodenal bulbar ulcer. Pathology of HGFs showed superficial gastritis, atypical hyperplasia, intestinal metaplasia, and glandular organ reduction. The rate of infection with H pylori was 84.98%. CONCLUSION： The rate of infection with H pylori, atypical hyperplasia and intestinal metaplasia in patients with HGF is higher than that for superficial gastritis, which may be related to gastric carcinogenesis.