114例高原红细胞增多症患者胃镜表现及临床特点分析

Endoscopic manifestations and clinical features of 114 patients with high altitude polycythemia

目的观察高原红细胞增多症(high altitude polycythemia,HAPC)患者的胃镜表现与临床特点,探讨两者间的关系。方法收集2010年1月-2015年12月于武警西藏总队医院住院期间行胃镜检查的高原红细胞增多症患者共114例,观察其内镜表现及临床特点,分析HAPC患者胃镜表现是否与患者性别、年龄、民族、部队身份、藏区居住时间、居住海拔高度有关。结果 114例HAPC患者罹患胃溃疡(GU)、非萎缩性胃炎伴糜烂(EG)、非萎缩性胃炎(NAG)、萎缩性胃炎(AG)、十二指肠球部溃疡(DU)、十二指肠球炎(DS)、反流性食管炎(ES)分别为27例、55例、26例、6例、31例、43例、15例;胃镜下表现以黏膜损伤性病变为主,以EG、DS最为常见。114例HAPC患者中,男性发病率明显高于女性,但差异无统计学意义(P>0.05);年龄<60岁者DU的发病率高于≥60岁者,年龄≥60岁者AG的发病率高于<60岁者,汉族GU、DU的发病率高于藏族,部队军人EG、DU的发病率高于地方人群,藏区居住时间≥5年者EG的发病率高于<5年者,差异均有统计学意义(P<0.05);另随着居住海拔高度升高,EG的发病率逐渐升高,差异有统计学意义(P<0.05)。结论 HAPC患者胃镜下表现以EG、DS最为常见,其内镜下表现与患者性别、年龄、民族、部队身份、藏区居住时间、居住海拔高度有关。

Objective To investigate the endoscopic manifestations and clinical features of the patients with high altitude polycythemia（ HAPC）. Methods One hundred and fourteen patients with HAPC who were hospitalized in Tibet Corps Hospital of PAP from Jan. 2010 to Dec. 2015 underground the gastroscope examination were collected. The endoscopic manifestations and clinical features of the patients were observed,and whether there were relationships of the endoscopic manifestations with the gender,age,ethic,military status,residence time in Tibet and living altitude of the patients with HAPC were analyzed. Results The numbers of cases of gastric ulcer（ GU）,non atrophic gastritis with erosion（ EG）,non atrophic gastritis（ NAG）,atrophic gastritis（ AG）,duodenal ulcer（ DU）,duodenitis（ DS）,esophagitis（ ES） were 27,55,26,6,31,43,15. The major lesions of the endoscopic manifestations were mucosal injury.The lesions of EG and DS were most popular. For the patients with HAPC,the incidence in the male population was obviously higher than that in the female population,but there was no statistically difference（ P〉0. 05）; the incidence of DU in the younger than sixty years old population was higher than that in the older than sixty years old population（ including the sixty years old）; the incidence of AG in the older than sixty years old population（ including the sixty years old） was higher than that in the younger than sixty years old population; the incidences of GU and DU in the Han nationality population were higher than that in the Zang nationality population,the incidences of EG and DU in the armyman population were higher than those in the population who did not served in the army,the incidence of EG in the population of residence time in Tibet over five years was higher than that in the population of shorter than five years,there were statistically differences（ P〈0. 05）. The incidence of EG was increased gradually as the living altitude rose gradually,there was statistically difference（ P〈0. 05）. Conclusion The lesions of EG and DS are the most popular endoscopic manifestations in the patients with HAPC; there are relationships between the endoscopic manifestations and the gender,age,ethic,military status,residence time in Tibet and living altitude of the patients with HAPC.