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目的探讨十二指肠炎(DI)的组织学诊断标准及内镜和组织学的关系。方法对70例十二指肠粘膜活检标本进行了炎症细胞及胃上皮化生的定量研究。结果正常十二指肠粘膜固有层间质炎性细胞数为3263±620.34个/mm~2,轻度 DI 为4279±478.45个/mm~2(P<0.01)。从球部正常粘膜到炎症,按Ⅰ-Ⅳ级计,胃上皮化生(GM)率依次为0%,37.9%,57.1%和73.3%,且化生范围逐渐增加。重度球部炎症88.2%能得到病理证实,轻度球部炎症为55.6%(P<0.01)。结论固有层间质炎性细胞数≥4000个/mm~2是诊断 DI 的依据。GM 是 DI的一个组织学特点。内镜下重度 DI 和正常粘膜多能得到病理组织学证实。
Objective To investigate the histological diagnostic criteria of duodenal inflammation (DI) and the relationship between endoscopy and histology. Methods 70 cases of duodenal mucosal biopsy specimens of inflammatory cells and gastric metaplasia quantitative study. Results The number of mesenchymal inflammatory cells in normal duodenal mucosa was 3263 ± 620.34 / mm ~ 2, mild DI was 4279 ± 478.45 / mm ~ 2 (P <0.01). From the normal mucosa of the ball to the inflammation, the rates of gastric epithelial metaplasia (GM) were 0%, 37.9%, 57.1% and 73.3%, respectively, according to grade Ⅰ-Ⅳ, and the range of metaplasia increased gradually. 88.2% of severe bulbar inflammation was confirmed by pathology, mild bulbar inflammation was 55.6% (P <0.01). Conclusion The number of innocuous mesenchymal inflammatory cells ≥ 4000 / mm ~ 2 is the basis of DI diagnosis. GM is a histological feature of DI. Severe endoscopic DI and normal mucosa can be histopathologically confirmed.