1、 Gastritis represents a nonspecific inflammation of the stomach.Clinically,the three most common and important causes of gastritis are infection of nonsteroidal anti-inflammatory drugs(NSAIDs),and stress-related mucosal changes.(5p334)Clinical features Nausea and vomiting are the most likely present
2、ing symptoms,together with indigestion.Acute gastrointestinal if gastritis is severe.Asymptomatic.(2p109)Diagnosis and investigation Often made on clinical grounds,e.g.History of non-steroidal anti-inflammatory drugs,heavy alcohol consumption,etc.Endoscopy appearance can vary from superficial erosio
3、ns to haemorrhage secondary to acute ulceration.(2p109)Superficial gastritis)(The inflammatory cell are confined to the pit rigion)(There is variable gland loss,which is often accompanied by intestinal metaplasia.)(Intestinal metaplasia)：(dysplasia)：Helicobacter pylori H.pylori is a gram-negative,cu
4、rved,flagellated rod found only in gastric epithelium or in gastric metaplastic epithelium.H.pylori is a noninvasive organism that colonizes the mucus layer overlying gastric epithelium.Factors important in the organisms ability to colonize the stomach to adhere to the mucus layer,and production of
5、urease.Urease increases juxtamucosal pH,creating a more hospitable microclimate than that of the acidic stomach.(5p334)Clinic features Most cases are asymptomatic.Symptoms are similar to those of acute gastritis,but occurring over a period of time.Pernicious anaemia due to loss of intrinsic factor secretion for vitamin B12 absorption occurs in patients with autoimmune gastritis.胃液分析胃液分析 血清学检查血清学检查 胃镜检查及活检胃镜检查及活检 幽门螺杆菌检查幽门螺杆菌检查 X线检查线检查 维生素维生素B12吸收检查吸收检查 幽门螺杆菌感染的胃炎治疗幽门螺杆菌感染的胃炎治疗 无幽门螺杆菌的胃炎治疗无幽门螺杆菌的胃炎治疗 巨大肥厚性胃炎巨大肥厚性胃炎 痘疹样胃炎痘疹样胃炎 残胃炎残胃炎 腐蚀性胃炎腐蚀性胃炎
