摘要
目的 研究高清晰放大胃镜下幽门螺杆菌（Hp）相关性胃炎胃粘膜的特点,观察Hp感染根除治疗后胃粘膜的变化。方法 使用Fujinon EG 485 ZH 85万像素高清晰放大电子胃镜,对50例门诊病例经常规胃镜检查后转换高清晰放大功能,详细观察胃体和胃窦粘膜的微细结构,判断Hp感染情况。结果50例中Hp阳性26例,普通胃镜判断Hp感染的敏感性为34.62％,准确性为58.00％,阳性拟然比为 2.08,阴性拟然比为 0.78;高清晰放大胃镜判断 Hp感染的敏感性为69.23％,准确性为78.00％,阳性拟然比为5.54,阴性拟然比为0.35。两种胃镜检查的Kappa值分别为0.176和0.563。结论Hp相关性胃炎的胃镜下表现主要是胃小凹不均匀发红,小凹变粗、变宽,集合静脉的模糊、混乱或消失。高清晰放大胃镜判断Hp感染的准确性明显高于普通胃镜。
Objective To investigate the gastric mucosal characteristics of Helicobacter pylori(Hp)-associated gastritis under high-resolution magnifying endoscopy. Methods Fujinon EG 485 ZH 850k CCD high-resolution electronic magnifying endoscopy was performed. Fifty patients were inspected by regular endoscopy with high-resolution magnifying function. Particular inspection was given on the collecting venules, the pit patterns of the gastric antrum and gastric body. Four pieces of biopsy specimen were taken, 1 each in antrum and body for RUT and the other two for pathologic examination as well as W-S stain. Both of the W-S stain and RUT being positive were confirmed as Hp infection. The Hp-positive patients received the triple therapy. Endoscopy with biopsies was repeated 4 weeks after the course of eradication treatment ended. The results were assessed by SPSS 8. 0 statistical package. Results Twenty-six patients were Hp-positive and 24 patients Hp-negative. In comparing with the results of W-S stain and RUT , the high-resolution magnifying endoscopy features and regular endoscopy findings had different outcomes. The sensitivity was 69. 23% Vs 34. 62% ; the accuracy 78.00% Vs 58. 00% respectively; the positive likelihood ratio and the negative likelihood ratio were 5. 54 Vs 2. 08 and 0. 35 Vs 0. 78 respectively. The Kappa value in high-resolution magnifying endoscopy was 0.563 whereas in regular endoscopy was 0. 176. Conclusions The advantage of high-resolution magnifying endoscopy relies on its ability to observe the fine gastric mucosal patterns. The gastric mucosal features of Hp-associated gastritis can be described as followings: collecting venules are irregular or disappeared; the gastric pits are enlarged or reddened, the sulciolar are deepened. Compared with regular endoscopy, the high-resolution magnifying endoscopy is better in sensitivity, accuracy and likelihood ratio. A high degree of interobserver agreement was obtained with the Kappa value. The pathologic findings get better soon after the eradication therapy, while the endoscopic changes are not prominent.
出处
《中华消化内镜杂志》
2002年第5期274-277,I002,共5页
Chinese Journal of Digestive Endoscopy
