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目的 :胃黏膜粗大皱襞的胃镜诊断与病因。方法 :对 6 8例首次胃镜下表现为胃黏膜粗大皱者襞进行胃镜及临床随访。结果 :胃黏膜粗大皱襞的病因有HP感染相关性胃炎 (47.1% ) ,皮革胃 (2 3 .5 % ) ,胃黏膜相关性淋巴瘤 (11.8% ) ,Menetrier病 (5 .9% ) ,其余艾 -卓综合症 ,嗜酸细胞性胃炎、甲减、慢性浅表性胃炎并肠化生(各占 2 .9% )。形成胃黏膜粗大皱襞的病因 70 .6 %具有胃镜下较典型形态特征 ,2 9.4%形态特征不典型 ,甚至少数胃良性病变胃镜表现为恶性征象 ,相反胃恶性病变仅表现为一般的炎症及糜烂 ,造成胃镜下误诊。胃镜及胃镜下病理确诊率为 82 .4% ,胃镜下多次多点活检 ,深凿活检、黏膜切除法及超声内镜可提高早期的诊断率。本组病例HP感染率高达 83 .8% ,根除HP感染可使胃黏膜粗大皱襞消失。结论 :胃黏膜粗大皱襞的病因最常见为HP感染相关性胃炎 ,其次为皮革胃、胃黏膜相关性淋巴瘤、Menetrier病。HP感染与胃黏膜粗大皱襞的形成关系密切 ,根除HP感染可作为其治疗的一种有效方法 ,胃镜、胃镜下病理及超声内镜是诊断胃黏膜粗大皱襞的有效手段
Objective: The diagnosis and etiology of gastric mucosa with coarse folds. Methods: Gastroscopy and clinical follow-up were performed on 68 cases of gastric mucosal coarse-grasping follicles under the first endoscopy. Results: The main causes of gastric mucosal coarse folds were HP infection-associated gastritis (47.1%), leather stomach (23.5%), gastric mucosa-associated lymphoma (11.8%) and Menetrier disease (5.9%), Ai - Zhuo syndrome, eosinophilic gastritis, hypothyroidism, chronic superficial gastritis and metaplasia (each 2.9%). Gastric mucosa formation of rough fold of the cause of 70.6% with typical morphological characteristics of endoscopy, 2 9.4% atypical morphological features, and even a small number of gastric benign lesions gastroscope showed signs of malignancy, on the contrary, gastric malignant lesions showed only the general inflammation and erosion , Resulting in misdiagnosis under endoscopy. Gastroscopy and endoscopy confirmed pathological diagnosis was 82.4%, multiple multi-biopsies under endoscopy, deep chisel biopsy, mucosal resection and endoscopic ultrasound can improve the early diagnosis. HP infection in this group of patients up to 83.8%, eradication of HP infection can make gastric mucosal thick folds disappear. Conclusions: The most common cause of gastric mucosal thick folds is HP-associated gastritis, followed by leather stomach, gastric mucosa-associated lymphoma and Menetrier’s disease. HP infection is closely related to the formation of coarse folds of gastric mucosa. Eradication of HP infection can be an effective method for its treatment. Endoscopy, endoscopic endoscopy and endoscopic ultrasonography are effective methods to diagnose gastric mucosal thick folds