Verrucous antral gastritis in relation to Helicobacter pylori infection,nutrition,and gastric atrophy  

疣状胃窦炎与幽门螺杆菌感染、营养状态及胃黏膜萎缩的相关性

作　　者：Naoko Tsuji Yasuko Umehara Mamoru Takenaka Yasunori Minami Tomohiro Watanabe Naoshi Nishida Masatoshi Kudo 

机构地区：[1]Department of Gastroenterology and Hepatology,Kindai University Faculty of Medicine,Osaka-Sayama,Japan

出　　处：《Gastroenterology Report》2020年第4期293-298,I0002,共7页胃肠病学报道（英文）

摘　　要：Background:There have been few studies in the English literature regarding verrucous gastritis(VG).The present study investigated the clinical and endoscopic features of verrucous antral gastritis,especially focusing on Helicobacter pylori infection,nutrition,and gastric atrophy.Methods:We performed a retrospective study of patients who underwent routine endoscopy with indigo carmine chromoendoscopy and a comparative study was conducted between VG-positive and VG-negative groups.VG was subdivided into classical and numerous types based on the number and distribution of verrucous lesions.Demographic,clinical,and endoscopic data including body mass index(BMI),serum albumin and cholesterol,gastric atrophy,reflux oesophagitis,Barrett’s oesophagus,and H.pylori status were collected.Univariate and multivariable analyses were performed to identify factors associated with VG.Results:We analysed the data of 621 patients undergoing routine endoscopy and found that VG(n=352)was significantly associated with increased BMI(1.12[1.05-1.18],P<0.01),reflux esophagitis(1.96[1.10-3.28],P<0.01),and H.pylori negativity with or without a history of eradication(9.94[6.00-16.47]and 6.12[3.51-10.68],P<0.001,respectively).Numerous-type(n=163)VG was associated with both closed-and open-type gastric atrophy(9.9[4.04-21.37]and 8.10[3.41-19.24],P<0.001,respectively).There were no statistical differences between groups regarding age,sex,total cholesterol,albumin,and bile-colored gastric juice.Conclusions:Verrucous antral gastritis was related to increased BMI,reflux esophagitis,and H.pylori negativity.Numerous-type verrucous lesions were associated with gastric atrophy.These indicate that VG may be a physiological phenomenon due to high gastric acidity,mechanical overload,and vulnerability of background mucosa.背景:英文文献中鲜有关于疣状胃窦炎(VG)的报道。本研究旨在分析VG的临床和内镜特征,重点关注幽门螺杆菌(Hp)感染、营养及胃黏膜萎缩。方法:本回顾性研究的对象为接受常规靛蓝胭脂红染色内镜检查的患者,对其中VG阳性与VG阴性病例进行比较。基于疣状病变的数量和分布,将VG进一步分为经典型和多灶型。收集人口统计学、临床及内镜资料,包括体质指数、血清白蛋白、胆固醇、胃黏膜萎缩、反流性食管炎、Barrett食管及Hp感染情况等。采用单因素和多因素分析明确VG发生的相关因素。结果:我们分析了621例常规内镜检查病例的相关资料,发现VG病例(352例)体质指数相对较高(OR 1.12,95%CI:1.05-1.18,P<0.01),更多伴随反流性食管炎(OR 1.96,95%CI:1.10-3.28,P<0.01),Hp阴性者比例更高,无论既往有Hp根治史(OR 9.94,95%CI:6.00-16.47,P<0.01)还是无Hp根治史(OR 6.12,95%CI:3.51-10.68,P<0.01)。与经典型VG相比,多灶型VG病例更多出现胃黏膜萎缩,包括闭锁型萎缩(OR 9.90,95%CI:4.04-21.37,P<0.001)和开放型萎缩(OR 8.10,95%CI:3.41-19.24,P<0.001)。年龄、性别、总胆固醇、血清白蛋白及胆汁色胃液方面的组间差异均无统计学意义。结论:VG的发生与高体质指数、反流性食管炎及Hp阴性有关;多灶型VG则多伴有胃黏膜萎缩。这些结果提示VG可能是一种由高胃酸状态、胃负荷过重及胃黏膜脆弱所引起的生理现象。

关 键 词：verrucous gastritis CHROMOENDOSCOPY BMI Helicobacter pylori ERADICATION gastric atrophy 

分 类 号：R573[医药卫生—消化系统]