慢性丙型肝炎患者胃十二指肠粘膜病变的研究  

Relationship between chronic viral hepatitis C and gastroduodenal mucosal lesions

作　　者：游晶 庄林[1,2] 唐宝璋 汤文辉[1,2] 刘宝源 

机构地区：[1]昆明市第三人民医院消化内科 [2]昆明医学院第一附属医院传染科

出　　处：《华人消化杂志》1998年第11期963-965,共3页

摘　　要：目的研究慢性丙型肝炎患者胃、十二指肠粘膜病变，探讨其发病机制．方法对经临床确诊的慢性丙型肝炎患者（简称丙肝组，３６例）与胃肠病患者（胃肠病组，８１例）进行内镜下对比研究．结果丙肝组和胃肠病组的ＰＵ，ＧＥＶ，ＤＩ，ＥＩ的发生率分别为６６７％，４１７％，６９４％，２７８％和３８３％，７４％，２８４％，６２％，二者间有显著性差异（Ｐ＜００１）；而两组的ＣＳＧ，ＥＧ，ＥＤ发生率分别为１０００％，２８％，２８％和９８８％，１２％，１２％，无统计学差异（Ｐ＞００５）．丙肝组中，活动型肝硬变的ＰＵ，ＤＩ，ＥＩ发生率（分别为８６７％，８６７％，５３３％）显著高于慢性肝炎重度和中度（分别为５３３％，５３３％，１３３％和５００％，６６７％，００％）（Ｐ＜００５），与肝炎的严重程度呈正比．同时具有２种以上粘膜病变者，丙肝组（６６７％）显著高于胃肠病组（３８３％，Ｐ＜００１）．肝硬变患者中ＧＥＶ轻中度７例，重度８例，同时具有３种以上粘膜病变者后者（１００％）显著多于前者（７１４％，Ｐ＜００１），且后者粘膜病变程度重于前者．丙肝组中ＨＣＶ单纯感染和ＨＣＶ与ＨＢＶ混合感染者?AIM To study the relationship between chronic viral hepatitis C (CHC) and gastroduodenal mucosal lesions (GDML) and the mechanism of GDML development in CHC patients. METHODS The patients ( n =117) were divided into 2 groups clinically before gastroscopy, CHC group ( n =36, male 31, female 5, 40 3±12 8 years) and gastroenteropathy (GEP) group ( n =81, male 53, female 28, 39 8±13 4 years) and observed through endoscopy. RESULTS The positivity rates of PU, GEV, DI and EI were 66 7%, 41 7%, 69 4% and 27 8% in CHC group, which were significantly higher as compared with GEP group (38 3%, 7 4%, 28 4% and 6 2%, P <0 01). No differences were demonstrated statistically in the occurrence rates of CSG, EG and ED between CHC and GEP groups (100 0%,2 8% and 2 8% vs 98 8%, 1 2% and 1 2%, P >0 05). The positivity rates of PU, DI and EI were obviously higher in patients with active liver cirrhosis (ALC) than those with chronic severe hepatitis (CSH) and other chronic hepatitis C (CHC) (86 7%, 86 7% and 53 3% vs 53 3%, 53 3%, and 13 3% and 50 0%, 66 7% and 0 0%, P <0 05). There was a remarkable correlation between the discovering rates of PU, DI and EI and the liver injury parameter in CHC patients. No differences were demonstrated statistically in the occurrence rates of PU, GEV, DI and EI between single infection and coinfection of HCV groups (80 0%, 20 0%, 80 0% and 20 0% vs 64 5%, 45 2%, 67 7%, and 29 0%, P >0 05). CONCLUSION GDMLs are common in CHC patients. There is a remarkable correlation between the GDML and the liver injury parameter. Liver functional disorder and HV infection play important roles in the development of GDML.

关 键 词：丙型肝炎 胃疾病 十二指肠疾病 内窥镜检查 

分 类 号：R512.630.2[医药卫生—内科学]