HIV感染者慢性胃炎胃镜表现及病理改变的相关研究  

Study on the endoscopic manifestations and pathological changes of chronic gastritis in HIV-infected patients

作　　者：郑会聪 郑啼婴 肖艳华[1] 李凌华[1] 许飞龙 罗红彬[1] 胡中伟[1] ZHENG Hui⁃cong;ZHENG Ti⁃ying;XIAO Yan⁃hua;LI Ling⁃hua;XU Fei⁃long;LUO Hong⁃bing;HU Zhong⁃wei(Department of Gastroenterology,Guangzhou Eighth People's Hospital,Guangzhou Medical University,Guangzhou,Guangdong 510180,China)

机构地区：[1]广州医科大学附属市八医院消化内科,广东广州510180

出　　处：《热带医学杂志》2022年第6期851-854,894,共5页Journal of Tropical Medicine

基　　金：广州市科技计划项目(202002020005)

摘　　要：目的研究探讨艾滋病病毒(HIV)感染者慢性胃炎的胃镜表现及病理改变。方法选取2018年1月-2020年12月在广州医科大学附属市八医院就诊并有慢性上消化道症状的40例HIV感染者,为实验组;其中包括无症状感染期患者与艾滋病(AIDS)期患者各20例,分别设为无症状感染期组和AIDS期组。同期在本院就诊并有慢性上消化道症状的非HIV感染者40例,为对照组。所有患者均行胃镜检查和病理活检。胃镜表现特点根据京都胃炎共识进行归纳,活检标本则进行常规病理诊断及幽门螺杆菌(Hp)检测;最后对比分析各组间胃镜表现和病理改变的差异。结果胃镜下诊断,实验组与对照组慢性胃炎均为40例(100%)。实验组中AIDS期患者的胃体小弯及胃角的集合细静脉规则性排列(RAC)、白浊粘液阳性率与对照组之间差异有统计学意义(χ^(2)=4.615、4.219,P均<0.05);实验组中无症状感染期患者的黏膜糜烂阳性率与AIDS期患者比较差异有统计学意义(χ^(2)=4.912,P<0.05)。通过病理诊断,实验组与对照组慢性胃炎均为40例(100%)。实验组的Hp阳性率与对照组之间差异有统计学意义(χ^(2)=11.375,P<0.05);AIDS期患者的慢性炎症程度、炎症活动度与对照组之间差异有统计学意义(χ^(2)=6.649、7.664,P均<0.05)。结论HIV感染者与非HIV感染者的慢性胃炎在胃镜表现及病理改变上存在差异,尤其是AIDS期患者与非HIV感染者间的差异更加明显。Objective To investigate the endoscopic manifestations and pathological changes of chronic gastritis in human immunodeficiency virus(HIV)-infected patients.Methods A total of 40 HIV-infected patients with chronic upper gastrointestinal symptoms treated in Guangzhou Eighth People’s Hospital,Guangzhou Medical Universit from January 2018to December 2020,were selected as the experimental group.There were 20 cases in asymptomatic infection stage and 20cases in AIDS stage,which were asymptomatic infection stage group and acquired immunedeficiency syndrome(AIDS)stage group.During the same period,40 non-HIV-infected patients with chronic gastrointestinal symptoms in our hospital were enrolled as the control group.All patients underwent gastroscopy and pathological biopsy.The features of gastroscopy were summarized according to the Kyoto consensus of gastritis,and routine pathological diagnosis and detection of Helicobacter pylori(Hp)were performed on biopsy specimens.Finally,the differences of gastroscopy and pathological changes among the groups were compared and analyzed.Results Both the experimental group and the control group were diagnosed with chronic gastritis under endoscopy in 40 cases(100%).There were significant differences in the positive rates of regular arrangement of collecting(RAC)in the lesser curvature and gastric angle and white mucous between the AIDS group of the experimental group(hereinafter referred to as the AIDS group)and the control group(χ^(2)=4.615,4.219,P<0.05).There was a significant difference in the positive rate of mucosal erosion between the asymptomatic infection stage group of the experimental group(hereinafter referred to as the asymptomatic infection stage group)and the AIDS stage group(χ^(2)=4.912,P<0.05).The pathological diagnosis of chronic gastritis in both experimental group and control group was 40cases(100%).There was a significant difference in the positive rate of Hp between the experimental group and the control group(χ^(2)=11.375,P<0.05).There were significant differ

关 键 词：HIV 慢性胃炎 幽门螺杆菌 胃镜 病理 

分 类 号：R573.3[医药卫生—消化系统]