案例#1
一名 42 岁男性近期出现腹痛、腹胀和恶心。幽门螺杆菌尿素呼气试验呈阳性。
案例#2
一名 58 岁、具有北欧血统的白人女性前来就诊,表现为近两个月乏力加重、行动困难和记忆缺陷。有明确的自身免疫疾病家族史。实验室检查可见明显的巨细胞贫血、血清维生素 B₁₂ 显著降低以及抗壁细胞抗体阳性。
其他表现
糜烂性胃炎可由以下因素引起:使用非甾体抗炎药 (NSAID)、饮酒或酒精滥用,[1]Varis K. Gastritis - a misused term in clinical gastroenterology. Scand J Gastroenterol Suppl. 1988;155:53-60.http://www.ncbi.nlm.nih.gov/pubmed/3245001?tool=bestpractice.com[2]Laine L, Weinstein WM. Subepithelial hemorrhages and erosions of human stomach. Dig Dis Sci. 1988;33:490-503.http://www.ncbi.nlm.nih.gov/pubmed/3280275?tool=bestpractice.com[3]Glickman JN, Antonioli DA. Gastritis. Gastrointest Endosc Clin N Am. 2001;11:717-740.http://www.ncbi.nlm.nih.gov/pubmed/11689363?tool=bestpractice.com 以及既往胃部手术或胆道手术(包括胆囊切除术)后胆汁反流入胃均可以引起糜烂性胃炎。[5]Bondurant FJ, Maull KI, Nelson HS Jr, et al. Bile reflux gastritis. South Med J. 1987;80:161-165.http://www.ncbi.nlm.nih.gov/pubmed/3810208?tool=bestpractice.com[6]Niemala S. Duodenogastric reflux in patients with upper abdominal complaints or gastric ulcer with particular reference to reflux-associated gastritis. Scand J Gastroenterol Suppl. 1985;115:1-56.http://www.ncbi.nlm.nih.gov/pubmed/3863229?tool=bestpractice.com[7]Niemala S, Karttunen T, Heikkila J, et al. Characteristics of reflux gastritis. Scand J Gastroenterol. 1987;22:349-354.http://www.ncbi.nlm.nih.gov/pubmed/3589504?tool=bestpractice.com[8]McAlhany JC Jr, Hanover TM, Taylor SM, et al. Long-term follow-up of patients with Roux-en-Y gastrojejunostomy for gastric disease. Ann Surg. 1994;219:451-455.http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1243166&blobtype=pdfhttp://www.ncbi.nlm.nih.gov/pubmed/8185395?tool=bestpractice.com 应激性胃炎(最常与黏膜缺血相关)可见于危重患者(一般为入住重症监护病房的患者)。[9]Martindale RG. Contemporary strategies for the prevention of stress-related mucosal bleeding. Am J Health Syst Pharm. 2005;62(suppl 2):S11-S17.http://www.ncbi.nlm.nih.gov/pubmed/15905595?tool=bestpractice.com 在自身免疫性胃炎中,抗壁细胞抗体刺激泌酸黏膜发生慢性炎性单核细胞和淋巴细胞浸润,导致胃体壁细胞和主细胞丢失。[3]Glickman JN, Antonioli DA. Gastritis. Gastrointest Endosc Clin N Am. 2001;11:717-740.http://www.ncbi.nlm.nih.gov/pubmed/11689363?tool=bestpractice.com[10]Kekki M, Siurala M, Varis K, et al. Classification principles and genetics of chronic gastritis. Scand J Gastroenterol Suppl. 1987;141:1-28.http://www.ncbi.nlm.nih.gov/pubmed/3481655?tool=bestpractice.com 化脓性胃炎是一种罕见却威胁生命的胃黏膜下层和固有基层的感染,见于免疫抑制的患者。[11]Shipman PJ, Drury P. Emphysematous gastritis: case report and literature review. Australas Radiol. 2001;45:64-66.http://www.ncbi.nlm.nih.gov/pubmed/11259977?tool=bestpractice.com[12]Dharap SB, Ghag G, Biswas A. Acute necrotizing gastritis. Indian J Gastroenterol. 2003;22:150-151.http://www.ncbi.nlm.nih.gov/pubmed/12962444?tool=bestpractice.com[13]Carlson AP, Chan WH, Ketai LH, et al. Emphysematous gastritis in a severely burned patient: case report and literature review. J Trauma. 2007;62:765-767.http://www.ncbi.nlm.nih.gov/pubmed/17414363?tool=bestpractice.com[14]Loi T, See JY, Diddapur RK, et al. Emphysematous gastritis: a case report and a review of literature. Ann Acad Med Singapore. 2007;36:72-73.http://www.ncbi.nlm.nih.gov/pubmed/17285190?tool=bestpractice.com