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] 

机构地区：[1]中山大学附属第二医院消化内科,广州510120

出　　处：《临床消化病杂志》2003年第6期259-260,共2页Chinese Journal of Clinical 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根除后 ,41 .7%患者的胃镜表现胃黏膜大致正常 ;33 .3 %患者表现为黏膜稍充血水肿和花斑样改变 (P <0 .0 5) ;2 5%患者的糜烂灶明显减少 ,主要为散在的平坦性糜烂 (P <0 .0 5) ,而隆起样糜烂消失 ,淋巴滤泡完全消失 ;66.7%患者无淋巴细胞浸润 ,33 .3 %患者为 1级改变。根除Hp后 ,淋巴细胞分级为 0 .33± 0 .49级 (P <0 .0 0 1 )。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。Purpose:To investigate the features of gastroscope and pathology of lymphocytic 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 duodenal lesions(40%). Findings of pathology: There was grade 3 of lymphocytes infiltration in all the sections, and lymphoid follicular formation was 58%. After Hp eradication, There was normal mucosa under gastroscope in 41.6% 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 25% cases(P<0.05), which mainly were scattered flat erosions; disappear of elevated erosions and lymphoid follicular; there was no lymphocytes infiltration in 66.7% cases and grade 1 in 33.3% 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 significant 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 幽门螺杆菌 随访 

分 类 号：R573.3[医药卫生—消化系统]