成人结节性胃炎32例临床分析  

Nodular Gastritis in Adults: A Clinical Analysis of 32 Cases

作　　者：张秋瓒[1] 刘晓红[2] 柯美云[2] 刘沙[2] 

机构地区：[1]天津市第四中心医院消化科,进修医师300140 [2]中国医学科学院中国协和医科大学北京协和医院消化内科,100730

出　　处：《胃肠病学》2005年第1期31-33,共3页Chinese Journal of Gastroenterology

摘　　要：背景:内镜下成人的结节性胃炎易与萎缩性胃炎相混淆而导致误诊。目的:总结分析成人结节性胃炎的临床特点和治疗方法,以提高对它的认识。方法:回顾性分析北京协和医院2001年1月～2003年7月诊断的成人结节性胃炎患者的临床、内镜、病理表现,以及幽门螺杆菌(H.pylori)感染情况和根除治疗的效果。结果:纳入分析的32例成人结节性胃炎患者中,男9例,女23例,年龄16～73岁,平均年龄35.8岁。主要临床表现为上腹痛(56.2%)和消化不良症状(37.5%),15.6%的患者伴有消化性溃疡。内镜下表现为以胃窦部为主,可扩展至胃体部的色泽均匀的结节样或颗粒样改变。病理检查显示75.0%的患者胃窦部活检标本中有伴生发中心的淋巴滤泡增生。所有患者均有H.pylori感染,经根除治疗后,症状缓解率达81.2%。结论:成人结节性胃炎是慢性胃炎的一种特殊内镜下表现,多见于年轻女性。其发生与H.pylori感染相关,是H.pylori感染的内镜下指标,患者应行根除H.pylori治疗。The endoscopic nodular gastritis in adults can be confused with atrophic gastritis and is easily to be misdiagnosed. Aims: To analyze the clinical features and therapeutics of nodular gastritis in adults so as to familiarize with its characteristics. Methods: The clinical presentations, endoscopic and histological findings, Helicobacter pylori (H.pylori) infection status, and the effect of eradication therapy in adult nodular gastritis patients were investigated retrospectively from January 2001 to July 2003 at Peking Union Medical College Hospital. Results: The mean age of the adult nodular gastritis patients enrolled in this study was 35.8 years (16～73 years), nine were male and 23 female. The major clinical manifestations were epigastric pain (56.2%) and dyspeptic symptoms (37.5%). Five patients (15.6%) were accompanied with peptic ulcer. Nodular gastritis is characterized by nodular or granular patterns in the antrum and (or) extending to the corpus endoscopically; 75.0% of the patients had germinal center of lymphoid follicle formation in their antral biopsy specimens. All 32 patients were positive forH.pyloriinfection, 26 patients (81.2%) were improved symptomatically after eradication. Conclusions: Nodular gastritis in adults is a special endoscopic finding of chronic gastritis and shows a predilection for young women. It may be caused byH.pyloriinfection, and an endoscopic indicator ofH.pyloriinfection.H.pylorieradication therapy is strongly recommended for patients with nodular gastritis.

关 键 词：结节性胃炎 临床分析 治疗 诊断 

分 类 号：R573.3[医药卫生—消化系统]