组织学改变对胃食管反流病的诊断价值  

Histological changes of gastroesophageal reflux disease and diagnosis value

作　　者：姜宗丹[1] 张振玉[1] 徐兆军[1] 罗新华[2] 黄文斌[2] 张弓羽[1] 王军洁[1] 

机构地区：[1]南京医科大学附属南京第一医院消化科,江苏南京210006 [2]南京医科大学附属南京第一医院病理科,江苏南京210006

出　　处：《临床荟萃》2011年第7期579-581,F0003,共4页Clinical Focus

摘　　要：目的对非糜烂性反流病（NERD）和糜烂性食管炎（RE）患者以及正常人的食管远端黏膜病理组织学进行比较分析,探讨其症状产生的机制。方法 104例受试者分为正常对照组20例、NERD组30例和RE组54例;在齿状线上2~3 cm取活检行光镜检查,观察其组织学改变,包括：①黏膜上皮细胞间隙增宽;②上皮细胞气球样膨胀;③乳头内毛细血管扩张、充血、乳头延长;④嗜酸性粒细胞、中性粒细胞浸润;⑤基底层过度增生,并对其进行统计学分析。结果反流相关病理组织学特征指标的总体检出情况：在组织学第①~⑤项中NERD与正常组的检出率差异有统计学意义（P〈0.05）,而NERD与RE组的检出率差异无统计学意义（P〉0.05）。结论 NERD患者与正常组远端食管组织通过光镜观察时病理改变明显,且差异有统计学意义,但与RE组比较差异无统计学意义。Objective To explore the mechanism of non-erosive reflux disease（NERD） and erosive esophagitis（RE） patients through the comparative analysis of distal esophageal mucosa histopathology between patients and normal people.Methods 104 subjects were divided into three groups,including normal control group（n=20）,NERD group（n=30）,and RE group（n=54）.In order to observe the histological changes,the biopsies were taken from 2-3 cm above the dentate line and these changes were examined by light microscopy,including： ①dilated intercellular space;②epithelial cells of balloon-like swelling;③telangiectasia,congestion in the nipple and nipple extending;④eosinophils,neutrophil infiltrates;⑤basal cell layer hyperplasia.And all the changes were analyzed statistically.Results The reflux related pathology characteristic index of the overall detected cases showed that the differences between NERD group and normal group beared statistical significance（P0.05）,while the differences between NERD and RE had no significance（P0.05） from the first to fifth item of histology.Conclusion This experiment shows that the remote esophageal tissue of GERD patients changes obviously under light microscope,and the differences have significant statistics,but no obvious difference exists between RE group and NERD group.

关 键 词：胃食管反流 组织学 诊断 

分 类 号：R571.9[医药卫生—消化系统]