幽门螺杆菌感染对慢性萎缩性胃炎萎缩边界内镜表现的影响  

Helicobacter pylori infection affects endoscopy signs of chronic atrophic gastritis border

作　　者：黄瑞 陈素玉[1] 陈建华 林娟[1] 蒋家莉 施宏[1] HUANG Rui;CHEN Su-yu;CHEN Jian-hua;LIN Juan;JIANG Jia-li;SHI Hong.(Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Endoscopic department, Fuzhou 350014, China)

机构地区：[1]福建省肿瘤医院,福建医科大学附属肿瘤医院,福建省肿瘤医院内镜科,350014

出　　处：《现代消化及介入诊疗》2020年第3期320-324,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：福建省卫生计生科研人才培养项目实施方案(2016-2018年)(闽卫科教[2015]131号);福建省卫生计生面向农村和城市社区推广适宜项目(2018008)。

摘　　要：目的探讨幽门螺杆菌(H.pylori)感染对慢性萎缩性胃炎(CAG)萎缩边界内镜下的影响。方法纳入符合研究标准的H.pylori阳性CAG感染患者186例,及H.pylori阴性CAG患者251例,H.pylori阴性CAG患者包含根除H.pylori治疗后的复查患者,分别予以白光及窄带成像技术(NBI)观察CAG边界,分析有无H.pylori感染的内镜影像表现,判定萎缩边界清晰度。结果CAG合并H.pylori感染萎缩边界可因黏液附着、黏膜充血水肿、反应样增生等而显示不清晰,NBI示萎缩界线不明显,与H.pylori阴性CAG患者萎缩边界清晰度相比存在统计学差异(P<0.05);其中随访42例根除H.pylori感染的CAG患者,1年内复查胃镜发现3例黏膜病变(2例低级别上皮内瘤变,1例黏膜内癌)。结论CAG根除H.pylori后萎缩边界更加清晰,黏膜充血水肿减轻,有利于发现黏膜病变,根除H.pylori后制定合理的随访方案,有利于提高黏膜病变发现率。Objective To investigate effect of Helicobacter pylori(H.pylori)infection on the atrophic boundary of chronic atrophic gastritis(CAG)under endoscopy.Methods 186 CAG patients with H.pylori positive and 251 CAG patients with H.pylori negative were included in the study.The CAG patients after H.pylori eradication treatment were included in the CAG patients with H.pylori negative.White light and narrow band imaging(NBI)were respectively used to observe the endoscopic performance of CAG boundary with or without H.pylori infection and determine the atrophic boundary.Results The CAG with H.pylori positive atrophic boundary can be not clear because of mucus adhesion,mucosal hyperemia,edema,and reaction hyperplasia,NBI shows that the atrophic boundary is not obvious,compared with the CAG patients with H.pylori negative atrophic boundary definition there were statistical differences(P<0.05),the 42 CAG patients with H.pylori eradication review gastroscope within 1 year,in which found 3 mucosal lesions(2 cases of low level intraepithelial neoplasia,1 case of intra-mucosal carcinoma).Conclusion After the eradication of H.pylori,the atrophic boundary is clearer and the mucosal congestion and edema is reduced,which is conducive to the detection of mucosal lesions.After the eradication of H.pylori,a reasonable follow-up program is formulated,which is conducive to the improvement of the detection rate of mucosal lesions.

关 键 词：慢性萎缩性胃炎 幽门螺杆菌 萎缩边界 早期胃癌 

分 类 号：R573.32[医药卫生—消化系统]