小儿胃炎及消化性溃疡组织学和血清学改变:附241例临床分析  

Histological and serological alteration in childhood gastritis and peptic ulcer: A clinical analysis of 241 cases

作　　者：丁肖英[1] 付玉梅[1] 沈林[1] 周怡和[2] 朱国清[2] 吴亚农[3] 

机构地区：[1]上海市第一人民医院儿内科,200080 [2]上海市第一人民医院胃镜室,200080 [3]上海市第一人民医院中心实验室,200080

出　　处：《临床儿科杂志》1998年第4期245-247,共3页Journal of Clinical Pediatrics

摘　　要：对我院儿科诊治的241例临床病例进行分析,作纤维胃镜检查220例(占本组病例的91.2％),其中157例为慢性浅表性胃炎(CSG);十二指肠溃疡61例,53例合并CSG;胃粘膜正常2例。213例作了HP胃粘膜快速脲素酶检测(HPUT),阳性83例,占受检病例的38.9％。107例作了组织学检查,全部病例未见胃粘膜肠化生或十二指肠胃型上皮化生。164例作了血清GAP-IgG检测,阳性117例(占71.3％),抗体滴度越高,粘膜损伤的程度越重;作血清GAP-IgM检测86例,阳性66例(占76.7％),均有明显的临床症状,粘膜HPUT阳性。故GAP-IgG可作为临床判断其病情程度的指标之一。GAP-IgM可作为检测现症病人的一个指标。小儿胃炎及消化性溃疡的组织学改变以胃粘膜炎症反应为主,未见胃粘膜肠化生或十二指肠胃型上皮化生发生,肠化生是发生胃癌的危险因素之一,这可能是小儿较少发生胃癌的原因之一。Two hundreds and forty-one children with childhood gastritis and peptic ulcer were analyzed in the article. The fibrogastroscopic examination was carried out in 220 (91. 2%) of them. In whom 157 cases showed chronic superficial gastritis (CSG), 61 cases had duodenal ulcer (CSG were coexisted in 53 cases of them) and only 2 cases appeared normal mucous membrane of the stomach. 213 cases had received the rapid urease test of mucous membrane for HP identification (HPUT), and 83 cases of them (38. 9%) showed positive results. Histology of mucous membrane were examined on 107 cases, no gastric-like epithelial mataplasia in duodunum or duodenal-like epithelial mataplasia in stomach were observed on all these cases. Otherwise, the serum GAP-IgG were detected in 164 cases, 117 cases of them (71. 3%) showed positive findings. The results showed that the higher the GAP-IgG litre was, the severer the damage of the mucous membrane would be. 86 cases received the measurement of serum GAP-IgM, and positive results were on 66 cases (76- 7%) who all showed obvious clinical symptoms with positive HPUT. It is suggested that GAP-IgG may be as one of indicators of judging disease situation, and GAP-IgM as a parameter of judging active patients. The present study showed that inflammation of mucous membrane might be predominate histologically in childhood gastritis and peptic ulcer, Svithout occurrence of gastric-like epithelial mataplasia in duodunum or doudenal-like epithelial mataplasia in stomach that usually were high risk factor of gastric cancer. It can be explained why children are rare to occur gastric cancer.

关 键 词：胃炎 消化性溃疡 组织学 血清学 儿童 

分 类 号：R725.733[医药卫生—儿科] R725.731[医药卫生—临床医学]