摘要
对我院儿科诊治的241例临床病例进行分析,作纤维胃镜检查220例(占本组病例的91.2％),其中157例为慢性浅表性胃炎(CSG);十二指肠溃疡61例,53例合并CSG;胃粘膜正常2例。213例作了HP胃粘膜快速脲素酶检测(HPUT),阳性83例,占受检病例的38.9％。107例作了组织学检查,全部病例未见胃粘膜肠化生或十二指肠胃型上皮化生。164例作了血清GAP-IgG检测,阳性117例(占71.3％),抗体滴度越高,粘膜损伤的程度越重;作血清GAP-IgM检测86例,阳性66例(占76.7％),均有明显的临床症状,粘膜HPUT阳性。故GAP-IgG可作为临床判断其病情程度的指标之一。GAP-IgM可作为检测现症病人的一个指标。小儿胃炎及消化性溃疡的组织学改变以胃粘膜炎症反应为主,未见胃粘膜肠化生或十二指肠胃型上皮化生发生,肠化生是发生胃癌的危险因素之一,这可能是小儿较少发生胃癌的原因之一。
Two hundreds and forty-one children with childhood gastritis and peptic ulcer were analyzed in the article. The fibrogastroscopic examination was carried out in 220 (91. 2%) of them. In whom 157 cases showed chronic superficial gastritis (CSG), 61 cases had duodenal ulcer (CSG were coexisted in 53 cases of them) and only 2 cases appeared normal mucous membrane of the stomach. 213 cases had received the rapid urease test of mucous membrane for HP identification (HPUT), and 83 cases of them (38. 9%) showed positive results. Histology of mucous membrane were examined on 107 cases, no gastric-like epithelial mataplasia in duodunum or duodenal-like epithelial mataplasia in stomach were observed on all these cases. Otherwise, the serum GAP-IgG were detected in 164 cases, 117 cases of them (71. 3%) showed positive findings. The results showed that the higher the GAP-IgG litre was, the severer the damage of the mucous membrane would be. 86 cases received the measurement of serum GAP-IgM, and positive results were on 66 cases (76- 7%) who all showed obvious clinical symptoms with positive HPUT. It is suggested that GAP-IgG may be as one of indicators of judging disease situation, and GAP-IgM as a parameter of judging active patients. The present study showed that inflammation of mucous membrane might be predominate histologically in childhood gastritis and peptic ulcer, Svithout occurrence of gastric-like epithelial mataplasia in duodunum or doudenal-like epithelial mataplasia in stomach that usually were high risk factor of gastric cancer. It can be explained why children are rare to occur gastric cancer.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
1998年第4期245-247,共3页
Journal of Clinical Pediatrics
