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胃黏膜相关淋巴组织淋巴瘤的临床特点及单纯根除幽门螺杆菌治疗的价值分析

(2014-10-22 12:26:09)

    【摘要】
    目的 汇总胃黏膜相关淋巴组织(MALT)淋巴瘤的临床特点并探讨单纯根除幽门螺杆菌(Hp)在治疗该病中的作用。

    方法 对95例胃MALT淋巴瘤患者中具有完整临床资料且能随访到的患者的临床表现、内镜下特征等进行回顾性总结,并对接受单纯根除Hp治疗患者的治疗情况及随访结果进行分析,采用KaplanMeier法绘制患者的生存曲线,多因素Cox回归法分析不同临床因素对单纯根除Hp反应的影响。

    结果 85例具有完整临床资料且能随访到的患者的临床表现、内镜下特征等无特异性。初诊患者Hp感染率为979%(93/95),其中36例接受单纯根除Hp治疗,总缓解率为94.4%(34/36),完全缓解率为66.7%(24/36),部分缓解率为27.8%(10/36),治疗无反应者2例。单纯根除Hp治疗者平均随访时间为(58.1±29.9)个月,去除生存时间不足3年的患者后采用KaplanMeier法绘制生存曲线,结果显示3年生存率为86.2%(25/29);多因素Cox回归法分析不同临床因素对单纯根除Hp反应影响的结果显示,患者年龄≥60岁、病变累及胃的多个部位(胃窦、胃体和胃底中至少两个部位)和内镜下糜烂浸润型是单纯根除Hp无反应的预测因子。

    结论 胃MALT淋巴瘤的发病与Hp感染密切相关,根除Hp可有效诱导疾病缓解。
    【关键词】幽门螺杆菌;胃黏膜相关淋巴组织淋巴瘤;三年生存率;临床特点


    Clinical characteristics of gastric mucosaassociated lymphoid tissue lymphoma and the effects of Helicobacter pylori eradication therapy
    CHEN Guang-xia*, JIANG Kui, WANG Bang-mao, FANG Wei-li, LIU Wen-tian, ZHENG Zhong-qing, ZHANG Ming-fang. *Department of Gastroenterology, Tianjin Medical University Hospital, Tianjin 300052, China
    Corresponding author: JIANG Kui,
    【Abstract】
    Objective  To review the clinical characteristics of patients with gastric mucosa-associated lymphoid tissue(MALT) lymphoma and to investigate the effects of Helicobacter pylori (Hp) eradication therapy in these patients.

    Methods  Clinical data of ninety-five patients with gastic MALT lymphoma were reviewed with respect to their clinical manifestations, endoscopic features, histopathological features and Hp infection. The follow-up data of patients treated by Hp eradication therapy were analyzed. The survival curve was calculated with Kaplan-Meier, while the predictive factors for resistance to Hp eradiation were then analyzed by using Cox proportional hazards model.

    Results  The clinical manifestations and endoscopic features of 85 patients with gastric MALT lymphoma were non-specific. Hp positive was found in 97.9% (93/95) patients at presentation, and 36 patients were treated by Hp eradication with a median follow-up duration of (58.1±29.9)months.Total remission was achieved in 94.4% (34/36), including 24 complete remission 10 partial remission. Therapy failure occurred in 2 patients. 3-year survival rate of patients treated by Hp eradication were 86.2%(25/29). Cox multivariate analysis showed that age (≥60 years), multiple lesions and non-superficial lesions were independent predictors of resistance to Hp eradication therapy. 

    Conclusion  Gastric MALT lymphoma is associated with Hp infection. Eradication of Hp can effectively induce remission in these patients.
    【Key words】Helicobacter pylori;Gastric mucosa-associated lymphoid tissue lymphoma;Three-year survival rate;Clinical Features

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个人资料
    王邦茂 单位:天津医科大学总医院
    所属科室:消化内科
    出生:1964-03-10
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