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胃囊性息肉病(胃底腺息肉)——与幽门螺杆菌感染缺失及抑酸药物治疗的关系

[Cystic polyposis of the stomach (fundic gland polyps)--relationship to the absence of Helicobacter pylori infection and a therapy with drugs suppressing gastric acidity].

作者信息

Fixa Bohumil, Vanásek Tomás, Volfová Miroslava, Nozicka Jan, Nozicka Zdenek

机构信息

Hepato-gastroenterologie s.r.o., Hradec Králové.

出版信息

Cas Lek Cesk. 2012;151(4):196-200.

Abstract

BACKGROUND

Cystic gastric polyps (fundic gland polyps) have been diagnosed relatively frequently in recent years. The aim of the study was to assess their incidence and relation to possible etiological factors reported in the literature.

MATERIAL AND METHODS

Over a 5 year period, we have endoscopically and histologically proved cystic polyps in 32 patients. All were examined for Helicobacter pylori infection using either the invasive rapid test, histological examination or 13C urea breath test.

RESULTS

Cystic gastric polyps were found significantly more frequently in women (27) than in men (5). All patients were treated with long-term medication suppressing gastric acidity (26 patients with proton pump inhibitors, and 6 with H2 receptor blockers). Helicobacter pylori infection was not detected in either of the patients with proven cystic gastric polyps. Cystic gastric polyps have not the typical clinical picture and they are largely found incidentally during gastroscopic examination, especially in patients with reflux esophagitis or functional dyspepsia.

CONCLUSION

The results confirm evidence in the literature of a close relation between cystic gastric polyps and intensive suppressive treatment of gastric acidity, particularly in combination with the current absence of Helicobacter pylori infection. Precise explanation of this relation and the etiology of cystic gastric polyps is still missing. Important is the fact that the literature reports do not indicate a risk of malignant transformation.

摘要

背景

近年来,囊性胃息肉(胃底腺息肉)的诊断相对较为频繁。本研究的目的是评估其发病率以及与文献中报道的可能病因之间的关系。

材料与方法

在5年的时间里,我们通过内镜检查和组织学检查证实了32例患者患有囊性息肉。所有患者均采用侵入性快速检测、组织学检查或13C尿素呼气试验检测幽门螺杆菌感染情况。

结果

发现囊性胃息肉在女性(27例)中比在男性(5例)中更为常见。所有患者均接受了长期抑制胃酸的药物治疗(26例患者使用质子泵抑制剂,6例患者使用H2受体阻滞剂)。在确诊为囊性胃息肉的患者中均未检测到幽门螺杆菌感染。囊性胃息肉没有典型的临床表现,大多是在胃镜检查时偶然发现的,尤其是在患有反流性食管炎或功能性消化不良的患者中。

结论

研究结果证实了文献中关于囊性胃息肉与强化胃酸抑制治疗之间密切关系的证据,特别是在目前不存在幽门螺杆菌感染的情况下。目前仍缺乏对这种关系以及囊性胃息肉病因的确切解释。重要的是,文献报道并未表明其有恶变风险。

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