蓝激光内镜联动成像模式对幽门螺杆菌感染相关性胃炎的诊断价值
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南方医科大学深圳医院,南方医科大学深圳医院,南方医科大学深圳医院消化内科,南方医科大学深圳医院消化内科,南方医科大学深圳医院消化内科,南方医科大学深圳医院消化内科,南方医科大学深圳医院消化内科,南方医科大学深圳医院消化内科

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Diagnostic value of linked color imaging technology for Helicobacter pylori-related gastritis
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Shenzhen Hospital of Southern Medical University,,,,,,,

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    摘要:

    目的 评价蓝激光内镜联动成像(LCI)观察模式在幽门螺杆菌(HP)感染相关性胃炎诊断中的价值。方法 2016年11月至2017年6月间,在南方医科大学深圳医院行蓝激光内镜检查诊断为慢性胃炎的40例患者作为研究对象,分别应用蓝激光内镜普通白光和LCI模式观察全胃黏膜外观形态,白光模式下依据慢性胃炎活检病理诊断共识取材,LCI模式下于异常发红部位取材,并行13碳尿素试验。使用Kappa分析检验2种方法与最终病理诊断的一致性,使用配对卡方检验分析2种方法间一致性的差异。结果 白光模式预测HP感染的阳性预测值为54.5%(6/11),与最终病理诊断的一致性为0.475(19/40),Kappa=0.635;LCI模式预测HP感染的阳性预测值为81.5%(22/27),与最终病理诊断的一致性为0.875(35/40),Kappa=0.741;配对卡方检验提示,预测结果与最终病理诊断的一致性2种内镜模式间差异有统计学意义(P<0.01)。40例均行13碳尿素试验,阳性19例,其中1例LCI模式下活检病理诊断为HP阴性;13碳尿素试验阴性21例,其中4例LCI模式下活检病理诊断为HP阴性: 两者诊断一致性良好,Kappa=0.751。黏膜存在红白边界,白光模式0例、LCI模式15例;黏膜弥漫发红,白光模式0例、LCI 模式11例:白光模式下黏膜外观形态与蓝光LCI模式下黏膜外观形态相比较,经秩和检验提示差异具有统计学意义(Z=-4.455,P<0.01)。结论 蓝激光内镜LCI观察模式较白光模式可明显提高HP感染相关性胃炎的诊断率,具有较好的临床使用价值。

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    Objective To evaluate the diagnostic value of linked color imaging (LCI) technology on Helicobacter pylori (HP)-related gastritis. Methods Forty patients who were diagnosed as chronic gastritis using blue laser imaging endoscopy in Shenzhen Hospital of Southern Medical University during November 2016 to June 2017 were enrolled in this study. The appearance of gastric mucosa was observed using conventional white light imaging and LCI. Biopsies were taken under white light imaging according to biopsy pathological diagnosis consensus, and the ones from abnormal reddening area were taken under LCI. 13C-urea breath test (13C-UBT) was performed in all 40 patients. The consistency between the two observation methods and final pathological diagnosis was evaluated using Kappa test, and the diagnostic consistency of the two methods was compared using Mc Nemar paired Chi-square test. Results The positive predictive value of white light imaging and LCI for prediction of HP infection was 54.5% (6/11) and 81.5% (22/27), respectively. The consistency between white light imaging diagnosis and final pathological diagnosis was 0.475 (19/40), Kappa=0.635; the consistency between LCI diagnosis and final pathological diagnosis was 0.875 (35/40), Kappa=0.741. Mc Nemar paired Chi-square test showed that the consistency between the two methods had significant difference (P<0.01). 13C-UBT showed that 19 patients were positive and 21 negative. Among the 19 positive patients, 1 case was diagnosed as HP negative by pathology under LCI; and among the 21 negative patients, 4 cases were diagnosed as HP negative by pathology under LCI. The consistency between pathological diagnosis and 13C-UBT was good (Kappa=0.751). The red-white boundary and diffuse redness of gastric mucosa were observed in 15 and 11 cases under LCI, respectively, while unobserved under white light imaging. The Wilcoxon signed ranks test showed that there was a significant difference between white light imaging and LCI on the appearance of gastric mucosa (Z=-4.455, P<0.01). Conclusion LCI is more useful for diagnosis of HP-related chronic gastritis than white light imaging.

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龚伟,朱颖,肖冰,等.蓝激光内镜联动成像模式对幽门螺杆菌感染相关性胃炎的诊断价值[J].中华消化内镜杂志,2018,35(6):381-384.

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  • 收稿日期:2017-11-04
  • 最后修改日期:2018-05-11
  • 录用日期:2018-01-02
  • 在线发布日期: 2018-06-19
  • 出版日期: 2018-06-20
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