Gastroscopic and pathological manifestations of Helicobacter pylori infected individuals confirmed by health examination
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摘要: 目的 回顾性分析健康体检幽门螺杆菌(HP)感染者胃镜及病理诊断,探讨体检筛查HP感染及胃镜检查的价值。方法 检索北京大学第一医院内镜中心数据库,纳入健康体检尿素呼气试验阳性接受胃镜检查的患者,分析胃镜及病理表现,并探讨其与症状、年龄的关系。结果 919例符合标准的HP感染者,慢性萎缩性胃炎(CAG)、胃溃疡及十二指肠溃疡的检出率分别为37.6%、4.5%和7.5%;病理中性粒细胞浸润、肠化、腺体萎缩、非典型增生的检出率分别为83.2%、30.3%、15.9%和0.3%,有无消化道症状两组胃镜及病理表现差异无统计学意义(P>0.05)。CAG检出率随年龄增加而增加(P<0.01),>40岁患者的构成比为89.6%,且以多灶点萎缩为主。结论 HP筛查应面向所有适宜筛查的成年人,而不论是否有消化道症状;健康体检HP感染者CAG检出率高,>40岁个体应进行胃镜检查指导随访策略。Abstract: Objective To evaluate the need for gastroscopy in Helicobacter pylori infected individuals confirmed by health examination. Methods The database of endoscopy unit of Peking University First Hospital was used to select the individuals who underwent gastroscopy after being positive in urea breath tests in health examination from October 2012 to December 2016 to analyze their gastroscopic and pathologic manifestations and explore the relationship between the symptoms and ages. Results Among 919 individuals infected with H. pylori,the detection rates of chronic atrophic gastritis(CAG),gastric ulcer and duodenal ulcer were 37.6%,4.5% and 7.5%,respectively,and the detection rates of neutrophil infiltration,intestinal metaplasia, atrophy and dysplasia were 83.2%,30.3%,15.9% and 0.3%,respectively. There were no significant differences in gastroscopic and the pathological manifestations between the individuals with or without dyspeptic symptoms(P>0.05). The detection rate of CAG increased with ages(P<0.01),the proportion of CAG patients aged >40 years accounted for 89.6% of the total and multifocal atrophy was the major pathologic type. Conclusion H. pylori infection screening should cover all suitable adults, regardless of having dyspeptic symptoms or not. The detection rate of CAG was high in H. pylori infected individuals confirmed by health examination. It is necessary to conduct gastroscopy and follow up in H. pylori infected individuals aged >40 years.
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Key words:
- Health examination /
- Helicobacter pylori /
- Gastroscopy /
- Pathology /
- Chronic atrophic gastritis
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