窄带成像下幽门螺杆菌感染时胃黏膜的特点  

Narrow-band imaging for gastric mucosal features of helicobacter pylori infection

作　　者：周晓永[1] 曲波[1] 尹桂琴[1] 陈光[1] 

机构地区：[1]哈尔滨医科大学第二临床医学院消化内科,黑龙江哈尔滨150000

出　　处：《中国内镜杂志》2010年第10期1027-1030,共4页China Journal of Endoscopy

摘　　要：目的探讨在放大内镜下应用窄带成像(NBI)技术观察幽门螺杆菌(Hp)感染时胃黏膜微细结构变化的特点。方法在放大内镜下应用NBI对170例有不同上消化道症状患者的胃黏膜微细结构进行观察和分型。用Warthin-starry银染色和患者血清Hp抗体以检测Hp感染。分析两者之间的相互关系。结果 170例患者中Hp感染阳性者69例,Hp感染阴性101例,胃体下部大弯侧集合静脉分为规则型(R)、不规则型(I)和消失型(D),Hp感染率分别为:6.67%、61.9%和84.75%,其中D及I型感染率明显高于R型,且差异有显著性(P<0.05)。胃窦部大弯侧胃小凹形态分为B、C、D、E4型,Hp感染发生率分别是22.22%、82.69%、27.78%和10.00%,C型感染率最高,与B、D、E3型比较差异有显著性(P<0.05),B、D、E3型间差异无显著性。结论在放大内镜及NBI下Hp感染时胃黏膜微细结构特点是集合静脉不规则、紊乱、模糊甚至消失;胃小凹稀疏延长、迂曲,小凹开口扩大、表面不均匀发红;且图像清晰度显著优于单独应用放大内镜。【Objective】To explore the microstructural features of gastric mucosa infecting helicobacter pylori by magnifying endoscopy with narrow-band imaging.【Methods】Microstructures of gastric mucosa in 170 patients with dyspepsia were observed and classified by magnifying endoscopy with narrow-band imaging. Biopsies were taken in the observed sites. Warthin-starry silver stain and helicobacter pylori antibodies in serum were used to detect the helicobacter pylori infection. The microstructures of gastric mucosa were compared with the results of the helicobacter pylori infection. 【Results】In the one hundred and seventy patients, the helicobacter pylori positive infections were sixty-nine, the contrary 101. The morphology of lower and greater curvature part of gastric corpus collecting venules was subdivided into type R （regular）, type I （irregular） and type D（disappeared）, correspondent helicobacter pylori infection rates were 6.67%, 61.9% and 84.75%. The rate of helicobacter pylori infection in type D and type I was significantly hither than that of type R （P 0.05）. The morphology of greater curvature part of gastric antrum pits was subdivided into type B, type C, type D and type E, correspondent helicobacter pylori infection rates were 22.22%, 82.69%, 27.78% and 10.00%, with type C significantly higher than that of type B, D and E （P 0.05）. 【Conclusion】Under magnifying endoscopy with narrow-band imaging, helicobacter pylori positive gastric mucosal microstructure shows the features of irregular, confused, obscured or disappeared collecting venules in corpus and the sparse but enlarged, tortuous or reddened gastric pit in antrum. The image clarity was significantly better than that of single application of magnifying endoscopy.

关 键 词：放大内镜 窄带成像 幽门螺杆菌 集合静脉 胃小凹 

分 类 号：R573.3[医药卫生—消化系统]