疣状胃炎653例分析

Analysis of 653 Patients with Gastritis Verrucosa

目的:探讨疣状胃炎的临床特点,以提高对此病的认识及诊疗水平。方法:收集明确诊断的653例疣状胃炎患者,均行电子胃镜检查,在病变部位取活检行病理检查,使用13C尿素呼气试验检测幽门螺杆菌(HP)。抽取56例HP阳性、50例HP阴性的中～重度患者,各再分为2组。HP阳性患者中A组给予兰索拉唑30mg,B组给予雷贝拉唑10mg,在此基础上2组均给予阿莫西林及呋喃唑酮,治疗1周,并于治疗结束4周后复查胃镜、病理及HP。HP阴性患者中C组给予兰索拉唑30mg,每日1次;D组给予西咪替丁0.2g,每日2次,治疗1周后再复查。结果:疣状胃炎的临床表现并无特异性,病变多位于胃窦部。病理为慢性胃炎或慢性活动性胃炎,伴肠上皮化生、不典型增生。HP感染的阳性率为72.74%,不同炎症程度患者的HP感染率差异有统计学意义(P<0.05)。经过1周治疗后,HP阳性A组治疗效果优于B组(P<0.05);HP阴性C组治疗效果优于D组(P<0.05)。结论:疣状胃炎发病可能与HP感染相关,且HP阳性率随着炎症程度的加重而增加,其治疗兰索拉唑、阿莫西林、呋喃唑酮三联治疗效果比较好。

Objective： To investigate the clinical characteristic of gastritis verrucosa,and improving the recognition and treatment of this disease thereof. Methods： Six hundred and fifty three patients with gastritis verrucosa,who were diagnosed in Tianjin general hospital from March 2003 to February 2009,were studied. All of these patients were examined by electronic gastroscope and conducted biopsy. Patients were detected helicobacter pylori （HP） using 13C urea breath test. Fifty eight pa- tients with HP-positive and fifty patients with HP-negative （moderate and serious grade）, were collected and divided into two groups respectively. The patients in HP-positive groups were given lansoprazole （group A） or rabeprazole （group B）. Furazolidone and amoxicilin were given in both groups. The patients in HP-negative groups were administered lansoprazole（group C） or cimetidine （group D）. The effects of the treatment were observed in this study. Results： There was no specificity in clinical characteristic of gastritis verrucosa. The pathological changes of gastritis verrucosa were mostly located antrum. The pathological manifestations were chronic inflammation and chronic active inflammation with intestinal metaplasia or atypical hyperplasia. The positive rate of HP infection was 72.74%. There was significant different in the relationship between different levels of inflammation and HP infection （P 0.05）. The effect of treatment was better in group A than that of group B（P 0.05）; and better in group C than that in group D （P 0.05）. Conclusion： There was a correlation between gastritis verrucosa and HP infection. The higher positive rate of HP was correlated with the degree of erosion. For patients with HP-positive, it is better to use the treatment of lansoprazole, amoxicillin and furazolidone. For patients with HP-negative, treatment with lansoprazole was bet- ter than cimetidine.