Clinical Experience of Adult Nodular Gastritis

成人結節性胃炎之臨床經驗

王仁助(Jen-Juh Wang) ； 張君照(Chun-Chao Chang) ； 劉正典(Jean-Dean Liu) ； 方嘉郎(Chia-Lang Fang) ； 陳盛煊(Sheng-Hsuan Chen) ； 潘憲(Shiann Pan)

《臺灣消化醫學雜誌》 24卷4期 (2007/12) Pp. 371-377

https://doi.org/10.6557/GJT.200712_24(4).0001

摘要

目的：結節性胃炎是一種成人比較少見的疾病，因此我們想探討台灣成人之結節性胃炎是否有特殊之臨床表徵。
材料及方法：回溯性收集自民國八十六年三月至民國九十四年二月期間，於台北醫學大學附設醫院就診，經由同一位內視鏡醫師實施上消化道內視鏡檢查並使用CLO test確定是否有幽門螺旋桿菌感染。
結果：在研究時期內共有8137位患者，接受了10293次的上消化道內視鏡檢查。有30位女病患及13位男病患被診斷爲結節性胃炎。大多數患者同時有消化性潰瘍，並且抱怨有上腹部的不舒服。88.4%的患者其CLO test是陽性的，而且全部都有侵犯到胃竇部。病理切片顯示有強烈發炎情形，且多數有淋巴濾泡的增生。滅菌後再追蹤的上消化道內視鏡檢查可見結節性胃炎明顯改善。
討論：結節性胃炎的發生率約爲0.5%，女性息者較多。大多數患者同時有消化性潰瘍，且跟幽門螺旋桿菌感染有強烈相關。然因病例有限，仍需更進一步的研究。
結論：實施上消化道內視鏡檢查時詳細檢查是必須的。如果有姿現結節性胃炎的話，應該要考慮安排滅菌計劃。

關鍵字

結節性胃炎 ； 幽門螺旋桿菌

並列摘要

Aim Nodular gastritis is not a common clinical entity. We want to investigate the clinical manifestations of adult nodular gastritis in Taiwanese patients.
Methods Patients over 18 years of age with varying degrees of discomfort and who had undergone esophagogastroduodenoscopy (EGD) by an experienced endoscopist at Taipei Medical University Hospital from March 1, 1997 to February 28, 2005, were enrolled. A Campylobacter-like organism (CLO) test was done for identification of Helicobacter pylori (H. pylori) infection. The clinical features of adult nodular gastritis were analyzed in this study.
Results A total of 8,137 patients underwent 10,293 EGD examinations during this period, and nodular gastritis was diagnosed in 30 women and 13 men. The incidence of adult nodular gastritis was about 0.5% (43/8137). More female (69.7%) patients were affected. More than 40% of the patients had peptic ulcer disease and more than 80% complained of epigastralgia at presentation. A CLO test was positive in 88.4% of these patients. The gastric antrum was always affected (100%). Pathology always revealed intense inflammation and 60% had lymphoid follicular hyperplasia. Remission of the gastric antral nodularity after eradication of H. pylori was also found.
Conclusion Adult nodular gastritis is a rare clinical entity in Taiwan. Careful endoscopic examination may be required. It has a strong association with H. pylori infection. H. pylori eradication may improve nodular gastritis.

並列關鍵字

nodular gastritis ； Helicobacter pylori