论文部分内容阅读
目的观察慢性浅表性胃炎(CSG)→萎缩性胃炎(CAG)→肠上皮化生(IM)→非典型增生(DYS)→胃癌(GC)五个不同阶段临床和胃镜表现及其与幽门螺杆菌(H.pylori)感染的关系。方法对经胃镜及病理证实的上述GC发生五个不同阶段的患者各50例,详细询问其临床症状,记录胃镜下表现,并用快速尿素酶试验(RUT)、14C尿素呼气试验(14C-UBT)、组织学检查及H.pylori培养等方法检测H.pylori感染情况。结果 (1)CSG和GC的临床表现分别以上腹胀和早饱、体重减轻为主,其他阶段均以上腹痛为主;(2)CSG、CAG和GC的胃镜下表现依次以疣状隆起及糜烂、黏膜变薄及血管显露、巨大溃疡及出血为多见,而IM和DYS均以直径小于2 cm的溃疡为多见(P<0.05);(3)H.pylori感染:从CSG→GC不同阶段,H.pylori感染率依次降低(分别为80%、78%、62%、56%和36%,P<0.05);临床表现中上腹痛及纳差H.pylori感染率高,早饱H.pylori感染率低(P<0.05);不同胃镜下表现中溃疡H.pylori感染率最高(P<0.05)。结论体重减轻可作为胃癌警示信号,胃镜下巨大溃疡及出血以GC多见;H.pylori感染率与GC发生阶段呈负相关,临床表现为上腹痛、纳差,及胃镜下溃疡患者H.pylori感染率高。
Objective To observe the clinical and gastroscopic features of chronic superficial gastritis (CSG) → atrophic gastritis (CAG) → intestinal metaplasia (IM) → atypical hyperplasia (DYS) → gastric cancer (GC) The relationship between H.pylori infection. Methods Fifty patients (50cases) were enrolled in the above-mentioned GC with gastroscopy and pathology. Five patients with different stages were enrolled in this study. Their clinical symptoms were investigated in detail. Gastroscopic findings were recorded and evaluated by rapid urease test (RUT), 14C urea breath test (14C-UBT ), Histological examination and H.pylori culture and other methods to detect H.pylori infection. Results (1) The clinical manifestations of CSG and GC were mainly abdominal distention, early fullness and weight loss, and the other stages were mainly abdominal pain. (2) The gastroscopic findings of CSG, CAG and GC followed by verrucous uplift and erosion, Mucosal thinning and blood vessels revealed, large ulcers and bleeding are more common, and IM and DYS are less than 2 cm in diameter ulcers are more common (P <0.05); (3) H. pylori infection: from CSG → GC different stages , H.pylori infection rate decreased in turn (80%, 78%, 62%, 56% and 36% respectively, P <0.05); clinical manifestations of upper abdominal pain and anaerobic H.pylori infection rate, early satiety H. The infection rate of pylori was low (P <0.05). The H.pylori infection rate was the highest in different endoscopy (P <0.05). Conclusion Body weight loss may serve as a warning sign of gastric cancer. Gastroscopic large ulcers and bleeding are more common with GC. H.pylori infection rate is negatively correlated with GC stage. The clinical manifestations include abdominal pain, anorexia, and gastric ulcer patients with H.pylori High infection rate.