目的

自身免疫性胃炎（AIG）是一种被低估的少见病，本研究旨在总结门诊筛查所见疑似AIG 并最终确诊的患者临床特征，并对患者进行分层管理，以实现个体化随访，避免远期出现较重并发症，影响生活质量。

方法

回顾性分析2023 年6 月至2023 年12 月天津市第三中心医院内镜中心经内镜诊断的AIG 患者的临床资料。 收集患者的基本信息；实验室检查：血常规、抗壁细胞抗体（PCA）、抗内因子抗体（IFA）、甲状腺功能、胃泌素Ⅰ/Ⅱ、G17、叶酸、VitB₁₂ 等指标。 符合正态分布的计量资料两组间比较采用t 检验；计数资料两组间比较采用Fisher 确切概率法。

结果

基于内镜筛查并确诊AIG 患者12例，男1例、女11例，平均年龄（66.08±12.92）岁。 伴发有增生性息肉患者3例（25%）、神经内分泌肿瘤患者2例（16.7%）、早期胃癌患者1例（8.3%）。 7例患者出现贫血，血红蛋白（Hb）平均值为（106.08±30.85）g/L，其中IFA 阳性的患者的Hb 的平均值显著低于IFA 阴性的患者。 7例患者完善了甲状腺功能检测，促甲状腺激素异常升高3例（42.9%）、甲状腺过氧化物酶抗体阳性6例（85.7%）、甲状腺球蛋白抗体阳性5例（71.4%）；胃功能检测9例，其中9例患者G17 与PGI 明显异常，2例（22.2%）出现PGII 异常。

结论

通过胃镜联合血清学确诊的AIG 患者中IFA 阳性组的更容易发生恶性贫血及相关胃内并发症，应该更加予以关注并随访管理。

Objective

Autoimmunegastritis（AIG）isanunderdiagnosed and rare disease. This study aims to summarize the clinical characteristics of patients suspected of AIG through outpatient screening and eventually diagnosed， as well as to stratify patient management to enable personalized follow-up and prevent long-term severe complications that may affect quality of life.

Methods

A retrospective analysis was performed on the clinical data of AIG patients diagnosed via endoscopy at the Endoscopy Center of Tianjin Third Central Hospital between June 2023 and December 2023. Basic information such as gender，reason for consultation， clinical manifestations， and family history were collected， along with laboratory tests including complete blood count， anti-parietal cell antibodies （PCA）， anti-intrinsic factor antibodies（IFA）， thyroid function， gastrin Ⅰ/Ⅱ， G17， folic acid， and vitamin B₁₂ levels. The t-test was used to compare normally distributed quantitative data between two groups， and Fisher's exact test was used for the comparison of categorical data.

Results

A total of 12 patients were diagnosed with AIG through endoscopic screening， with a male-to-female ratio of 1 ∶11 and an average age of 66.08±12.92 years. Three patients（25%） had associated hyperplastic polyps， two patients （16. 7%） had neuroendocrine tumors， and one patient （8. 3%） had early-stage gastric cancer. Seven patients presented with anemia， with an average hemoglobin （Hb） level of （106. 08±30. 85） g/L. The average Hb level in IFA-positive patients was significantly lower than in IFA-negative patients. Thyroid function tests were completed in seven patients，with three cases （42. 9%） showing elevated thyroid-stimulating hormone （TSH）， six cases （85. 7%）positive for thyroid peroxidase antibodies， and five cases （71. 4%） positive for thyroglobulin antibodies.Gastric function tests were completed in nine patients， with abnormal G17 and PGI levels in all cases， and two cases （22.2%） showing abnormal PGII levels.

Conclusion

Among AIG patients diagnosed through combined endoscopy and serology， those in the IFA-positive group are more prone to developing pernicious anemia and associated gastric complications， and therefore require closer attention and follow-up management.