摘要
目的探讨幽门螺杆菌(HP)及产毒株(Tox+HP)在疣状胃炎(VG)发生中的作用,了解胃黏膜肠上皮化生及异型增生在VG时的发生情况,观察药物(质子泵抑制剂,三联疗法抗HP)及内镜下微波疗法对于VG的确切疗效。方法通过胃镜检查将VG分为成熟型(MVG)和非成熟型(UMVG)两类,每例均进行病理观察,HP感染分为HP感染阴性和阳性,根据以上情况将患者分为8组,分别予以药物治疗及微波治疗,比较各组HP及Tox+HP感染、胃黏膜肠上皮化生及异型增生及不同疗法的效果情况,并与91例慢性浅表活动性胃炎(对照组)患者相对照。结果疣状胃炎时HP感染率高于对照组,以Tox+HP感染为主;胃黏膜肠上皮化生及异型增生在MVG组明显高于对照组,UMVG组稍高于对照组,但差异无统计学意义;对于UMVG,单纯药物治疗一月治愈好转率达88%～94%,微波疗法治愈好转率达近100%;对于MVG,单纯药物治疗1月治愈好转率达28%～35%,微波疗法治愈好转率达近100%。结论HP尤其Tox+HP的感染在VG的发生中起了重要的作用,在VG尤其MVG时胃黏膜肠上皮化生及异型增生发生率高于对照组,说明VG有癌变倾向;单纯药物(质子泵抑制剂,三联疗法抗HP)疗法对于UMVG有效,对于MVG疗效差;内镜下微波疗法适用于MVG及药物治疗效果不理想的UMVG患者。
Objective To investigate the role of Helicobacter pylori（HP）and toxinum HP strain（Tox＋ HP）in the occurrence of varioliform gastritis（VG）and gastric pathological changes such as metaplasia and intraepithelial neoplasia in varioliform gastritis,and to evaluate the therapeutic effect of omeprazole and microwave therapy.Methods Two hundred and two selective patients with VG were classified randomly into eight groups according to the status of HP and the features of varioliform erosions,the prevalence of HP and Tox＋HP were studied respectively in patients with mature varioliform gastritis（MVG）and immature varioliform gastritis（IMVG）Pathological changes such as metaplasia and intraepithelial neoplasia were examined.Different therapies including omeprazole and microwave therapy were taken in different groups and the results were compared.Results Tox＋HP positive rates in patients with MVG and IMVG groups（48.0% and 42.2% respectively）were higher than that in control group（24.2%）.There was no statistical difference in the occurrence of metaplasia and intraepithelial neoplasia among MVG,IMVG and control groups.The improvement rates of omeprazole treatment（one month）and microwave therapy were 88-94% and near 100% respectively in IMVG group,whereas,the improvement rates of omeprazole treatment（one month）and microwave therapy were 28-35% and near 100% respectively in MVG group.Conclusion Tox＋HP infection may play an important role in the occurrence of MVG and IMVG.Omeprazole shows better therapeutic effect for the treatment of IMVG than that of MVG.Endoscopic microwave therapy can be used in MVG patients and IMVG patients who failed to the treatment of omeprazole.
出处
《临床和实验医学杂志》
2009年第11期9-11,13,共4页
Journal of Clinical and Experimental Medicine
关键词
疣状胃炎
幽门螺杆菌
肠上皮化生
异型增生
药物疗法
微波疗法
varioliform gastritis
Helicobacter pylori
Metaplasia
Intraepithelial neoplasia
Drug therapy
Microwave therapy
