摘要
目的了解胃粘膜肠上皮化生及不典型增生在胃肠道疾病中的发生率，及其与胃癌的关系．方法病例来自１９８６０１／１９９５１２中山医院进行内镜检查的患者．２６５７８例，男１７０９２例（６４３％），女９４８０例（３５７％），检出胃癌５３８例（２０％）；胃溃疡２５６９例（９７％）；十二指肠溃疡６１２７例（２３１％）；复合溃疡８４１例（３２％）．比较各组肠上皮化生及不典型增生的检出率．结果肠上皮化生检出率为３３９％，随年龄增加而增加，在胃癌组［４９８％，ＯＲ＝１７８（９５％ＣＩ１４９～２３１）］，胃溃疡组［５１６％，ＯＲ＝２１２（９５％ＣＩ１９５～２３１）］明显高于慢性胃炎组（３３４％）．总的不典型增生检出率为（５１％），随年龄增加而增加．胃癌组［１６２％，ＯＲ＝４８７（９５％ＣＩ３７８～６２６）］，胃溃疡组［１３２％，ＯＲ＝３８２（９５％ＣＩ３３１～４４１）］，复合溃疡组［１１７％，ＯＲ＝３３５（９５％ＣＩ２６５～４２２）］明显高于慢性胃炎组（３８％）．结论肠上皮化生及不典型增生的发生随年龄增加而增加．在胃癌及胃溃疡患者中，其发生率明显高于慢性胃炎患者．肠上?
IM To study the incidence rate of intestinal metaplasia and dysplastic changes in chronic gastritis. METHODS All 26 578 patients (17 092 male, 643%; 9486 female, 357%) undergoing endoscopic examination in this hospital from January 1986 to December 1995 were selected. They were classified as having chronic gastritis, gastric ulcer, combined ulcer, duodenal ulcer and gastric carcinoma. The incidence rate of intestinal metaplasia and dysplastic changes were compared among these groups. RESULTS There were 538 cases of gastric carcinoma (20%), 2569 gastric ulcer (97%), 841 combined ulcer (32%), and 6127 duodenal ulcer (231%). The detective rate of intestinal metaplasia was 339%, which was increased with age. The rates in gastric carcinoma[498%, OR=178(95% CI 149-231)] and gastric ulcer [516%, OR=212 (95% CI 195-231)] were higher than that in chronic gastritis (334%). The detective rate of dysplastic changes was 51%, which was increased with age. The rates in gastric carcinoma [162%,OR=487(95% CI 378-626)], gastric ulcer [132%,OR=382 (95% CI 331-441)] and combined ulcer [117%, OR=335 (95% CI 265-422)] were higher than that in chronic gastritis (38%). CONCLUSION The detective rates of intestinal metaplasia and dysplastic changes are increased with age, higher in gastric carcinoma and gastric ulcer than that in chronic gastritis..
