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目的研究慢性胃炎伴良性结节状改变与幽门螺杆菌(Hp)及胃黏膜淋巴滤泡的关系。方法从2004年7月1日-2005年6月30日行内镜检查患者中,筛选出胃窦黏膜有良性结节样改变者为研究对象,在患者胃窦黏膜处喷洒靛胭脂作色素内镜观察,确定有结节状形态改变,并在有明显结节处取活检组织3块,其中1块立刻作Hp快速试验.判定有无Hp感染;另外2块送病理检查,观察胃黏膜淋巴滤泡形成和淋巴细胞漫润情况,并采用亚甲蓝-硼酸染色法进一步明确诊断Hp感染情况。结果将胃黏膜良性结节状改变的慢性胃炎患者分为三组:结节性胃炎组、萎缩性胃炎组和疣状胃炎组,患者平均年龄分别为(31.00±11.62)岁、(58.61±12.14)岁和(51.29±12.99)岁,其中结节性胃炎组患者发病年龄最小(P<0.01);Hp感染率分别为92.86%、82.56%和69.89%,其中结节性胃炎组的感染率明显高于其他两组(P<0.01);有淋巴组织增生所见依次为94.90%、27.9%、18.28%,其中结节性胃炎患者淋巴组织增生明显高于其他胃炎患者(P<0.01)。伴有结节样改变的萎缩性胃炎患者中萎缩和肠化生百分率分别为100%和59.3%,远高于疣状胃炎组的7.53%、8.60%和结节状胃炎组的4.03%、0.00%。结论在三种常见的胃黏膜良性结节状改变的胃炎中,结节性胃炎与Hp感染及胃黏膜淋巴滤泡形成之间存在密切相关性。可以把Hp感染及淋巴组织滤泡形成和淋巴细胞浸润作为诊断结节性胃炎的病理诊断依据。
Objective To study the relationship between chronic gastritis with benign nodules and Helicobacter pylori (Hp) and gastric mucosal lymphoid follicles. Methods From July 1, 2004 - June 30, 2005 endoscopic examination of patients, screening out the gastric mucosa with benign nodular changes in the study as the object, in patients with antral gastric mucosa spray indigo rouge pigment Microscopic observation showed that there were nodular changes in morphology, and there were 3 biopsy tissues with obvious nodules, of which 1 was immediately tested by Hp to determine whether there was Hp infection and the other 2 were pathologically examined to observe gastric mucosal lymph Follicular formation and lymphocyte infiltration, and methylene blue - boric acid staining method to further confirm the diagnosis of Hp infection. Results The patients with chronic gastritis with benign nodular changes of gastric mucosa were divided into three groups: nodular gastritis group, atrophic gastritis group and verrucous gastritis group. The average age of patients with chronic gastritis was (31.00 ± 11.62) years old, (58.61 ± 12.14) ) And (51.29 ± 12.99) years old respectively, of which the age of onset was the lowest in patients with nodular gastritis (P <0.01). The infection rates of Hp were 92.86%, 82.56% and 69.89% Higher than the other two groups (P <0.01). There were 94.90%, 27.9% and 18.28% of lymphoid hyperplasia, respectively. The lymphoid tissue hyperplasia of nodular gastritis patients was significantly higher than that of other gastritis patients (P <0.01). The percentages of atrophy and intestinal metaplasia in patients with atrophic gastritis accompanied by nodular changes were 100% and 59.3%, respectively, much higher than those in verrucous gastritis group (7.53%, 8.60% and nodular gastritis group, 4.03%, 0.003 %. Conclusion Among the three common gastritis with benign nodular changes, there is a close relationship between nodular gastritis and Hp infection and gastric mucosal lymphoid follicle formation. Hp infection can be formed and lymphoid follicular formation and lymphocyte infiltration as the diagnosis of nodular gastritis pathological diagnosis.