淋巴细胞性胃炎的内镜和病理特点及随访分析  

Analysis of features of endoscope and pathology and data of follow up in patients with lymphocytic gastritis.

作　　者：钟英强[1] 陈为宪[1] 朱兆华[1] 李海刚[1] 

机构地区：[1]中山大学附属第二医院消化内科,广州510120

出　　处：《现代消化及介入诊疗》2002年第4期13-15,共3页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的探讨淋巴细胞性胃炎(LCG)的内镜、病理特点,以及根除幽门螺杆菌(Hp)后对其的影响。方法分析50例LCG的电子胃镜表现和病理所见,应用分级法评价淋巴细胞的浸润程度,应用PPI三联疗法根除Hp。结果 LCG多见于中年男性,Hp感染率为84％。内镜特点:90％以上的病变位于胃窦和胃体的下段,特征性表现为多发性或弥漫性隆起样糜烂或脐样糜烂,共占70％,可并发十二指肠球部病变,占40％。病理特点:全部组织均有淋巴细胞浸润,淋巴滤泡形成占58％。Hp的根除后,5/12例胃镜表现胃粘膜大致正常:4/12例表现为粘膜稍充血水肿和花斑样改变,占33.3％(P<0.05);3/12例糜烂灶明显减少,主要为散在的平坦性糜烂,占25％(P<0.05),而隆起样糜烂消失;淋巴滤泡完全消失:8/12例无淋巴细胞浸润,4/12例为1级改变,根除Hp后,淋巴细胞分级为0.33+0.49级(P<0.001)。结论 LCG有一定的内镜和病理特点。根除Hp后,可明显减少淋巴细胞的浸润,且可治愈LCG。Objective To investigate the features of gastroscope and pathology of lympho-cytic gastritis(LCG), and effect on them after Helicobecter pylori(HP) eradication. Methods Analysis of manifestations under gastroscope and findings of pathology were made in 50 patients with LCG. Lymphocytes infiltration were assessed by grading and HP was eradicated by PPI-based triple therapy. Results. LCG was common in mid-aged the male. The rate of HP infection was 84%. The manifestations under gastroscope: Above 90% lesions were found in gastric antrum and the lower of corpus. The characterizations were multiple or diffused elevated erosions or umbilicus-liked erosions(70%). They could complicate deudenal lesions(40%). Findings of pathology: There was grade 3 of lymphocytes infiltration in all the sections, and Iymphoid follicular formation was 58%. After Hp eradication, There was normal mucosa under gastroscope in 5/12 cases, and a little of mucosa congestion, swelling and erythema in 33.3% cases(p<0.05); There was a significant reduction of erosions in 3/12 cases(p<0.05), which mainly were scattered flat erosions; Disappear of elevated erosions and Iymphoid follicular; There was no lymphocytes infiltrationin 8/12 cases and grade I in 4/12 cases; The mean grading of lymphocytes infiltration was 0.33±0.49 (P<0.001). Conclusions There were some features of endoscope and pathology in the patients with LCG. There was a signi-ficant reduction of lymphocytes infiltration and healing of LCG after Hp eradication.

关 键 词：淋巴细胞性胃炎 内镜 病理特点 诊断 随访分析 

分 类 号：R573.3[医药卫生—消化系统]