鄱阳湖区血吸虫病和非血吸虫病患者胃镜下表现与病理学特征

Gastroscopic and pathological characteristics of patients with or without schistosomiasis in Poyang Lake area

目的了解鄱阳湖区血吸虫病与非血吸虫病患者胃镜下表现及病理学特征,探讨血吸虫病与胃黏膜病变的关系。方法将疫区志愿者按是否患血吸虫病分成病例组和对照组,对两组进行胃镜检查及多部位取组织病理检查。结果 253例慢性或晚期血吸虫病患者胃镜下均有不同程度胃黏膜改变,病理检查发现胃黏膜下有血吸虫卵者7例,发生率为2.77%;异形增生、不完全性大肠上皮化生(癌前病变)者共33例,发生率为13.04%;胃癌1例。检查非血吸虫病患者200例,发现异型增生、不完全性大肠上皮化生者15例,检出率为7.50%;胃癌1例。两组异型增生和不完全性大肠上皮化生的发生率差异无统计学意义(P>0.05)。结论血吸虫病患者胃黏膜病变发生率与程度高于非血吸虫病患者,胃十二指肠血吸虫病与胃癌的发生则无明显相关。

Objectives To understand the gastroscopic and pathological characteristics of patients with or without schistosomiasis in Poyang Lake area,and to explore the relationship between schistosomiasis and pathological changes of gastric mucosa.Methods Volunteers with or without schistosomiasis were recruited and divided into a case group and a control group.All the objects were examined by electronic gastroscopy and pathological examinations.Results Two hundred and fifty-three volunteers diagnosed with chronic or advanced schistosomiasis in the case group showed different degrees of gastric mucosal changes,including 7 cases with schistosomal eggs deposited beneath the gastric mucosa（with an incidence of 2.77%）,33 cases with dysplastic hyperplasia and intestinal metaplasia（with an incidence of precancerous lesion of 13.04%）,and 1 case with gastric cancer.While in the 200 volunteers without schistosomiasis in the control group,the results showed milder gastric mucosal changes,33 cases were detected with dysplastic hyperplasia and intestinal metaplasia（with an incidence of 7.50%）,and 1 case was diagnosed gastric cancer.The difference between the incidences of precancerous lesion in the two groups had no statistic significance（P 0.05）.Conclusions The incidence and extent of gastric mucosal changes in schistosomiasis patients are higher and more serious than those in non-schistosomiasis patients,and gastrointestinal schistosomiasis is not related to gastric cancer.