胃黏膜粗大皱襞的胃镜诊断与病因分析  

ENDOSCOPIC DIAGNOSIS AND ETIOLOGY ANALYSIS WITH HYPERTROPHIC GASTRIC FOLDS

作　　者：鞠爱红[1] 牟正彬[1] 明俊英[1] 

机构地区：[1]山东省烟台市毓璜顶医院,264000

出　　处：《中国内镜杂志》2002年第1期57-61,共5页China Journal of Endoscopy

摘　　要：目的 :胃黏膜粗大皱襞的胃镜诊断与病因。方法 :对 6 8例首次胃镜下表现为胃黏膜粗大皱者襞进行胃镜及临床随访。结果 :胃黏膜粗大皱襞的病因有HP感染相关性胃炎 (47.1% ) ,皮革胃 (2 3 .5 % ) ,胃黏膜相关性淋巴瘤 (11.8% ) ,Menetrier病 (5 .9% ) ,其余艾 -卓综合症 ,嗜酸细胞性胃炎、甲减、慢性浅表性胃炎并肠化生(各占 2 .9% )。形成胃黏膜粗大皱襞的病因 70 .6 %具有胃镜下较典型形态特征 ,2 9.4%形态特征不典型 ,甚至少数胃良性病变胃镜表现为恶性征象 ,相反胃恶性病变仅表现为一般的炎症及糜烂 ,造成胃镜下误诊。胃镜及胃镜下病理确诊率为 82 .4% ,胃镜下多次多点活检 ,深凿活检、黏膜切除法及超声内镜可提高早期的诊断率。本组病例HP感染率高达 83 .8% ,根除HP感染可使胃黏膜粗大皱襞消失。结论 :胃黏膜粗大皱襞的病因最常见为HP感染相关性胃炎 ,其次为皮革胃、胃黏膜相关性淋巴瘤、Menetrier病。HP感染与胃黏膜粗大皱襞的形成关系密切 ,根除HP感染可作为其治疗的一种有效方法 ,胃镜。Objective:To analyze the endoscopic diagnosis and etiology with hypertropic gastric folds(HGF) Method:68 Cases with HGF on first endoscopy view undertook clinical and endoscopy following up.Results:The etiologies of HGF were H.pylori-associated gastritis(47.1%)?gastric linitis plastica(23.5%)?mucosa-associated lymphoid tissue lymphoma(MALT lymphoma)(11.8%),menetrier's disease(5.9%)?zollinger-ellison syndrome?hypothyroidism, eosinophilic gastritis?chronic superficial gastritis in association with intestinal netaplasia(2.9%).The 70.6 percent etiologies of HGF are possessed of individual and very special endoscopy features,other with few untypical outlook like erosions.Positive findings by endoscopy and biopsies attained 82.4%,the percentage rose up with more biopsies taken from multiple sites,mucosal cerips?deep bites and endoscopic ultrasound(EUS).Positive rate of H.pyolri infection were in creased 83.8% the width of HGF can be disappenranced after eradication of H.pylori. Conclusions:The etiologise of HGF are particularly common in H.Pylory-associated gastritis,in the second place,in gastric linitis plastica, MALT lymphoma and menetrier's disease,infection of H.pylori is now considered to be one of the possible pathogent of the HGF.Eadication of H.pylori was regard as a valuoble treatment for HGF.gastroscopy?pathological examination and EUS remain to be valuable to test correct diagnosis of HGF.

关 键 词：胃黏膜粗大皱襞 病因 胃镜检查 HP感染 组织活检 

分 类 号：R573.04[医药卫生—消化系统]