窄带成像放大内镜检查联合血清指标检测对慢性萎缩性胃炎的诊断价值  

Value of narrow band imaging-magnifying endoscopy combined with serum indexes detection in the diagnosis of chronic atrophic gastritis

作　　者：章程 成鉴晓 巩芮宁 江月萍[1] Zhang Cheng;Cheng Jianxiao;Gong Ruining;Jiang Yueping(Department of Gastroenterology,the Affiliated Hospital of Qingdao University,Shandong,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院消化内科,山东青岛266000

出　　处：《中国医学前沿杂志（电子版）》2020年第5期141-144,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探究窄带成像放大内镜检查(narrow band imaging-magnifying endoscopy,NBI-ME)联合血清指标检测对慢性萎缩性胃炎(chronic atrophic gastritis,CAG)的诊断价值。方法选取2018年9月至2019年10月青岛大学附属医院收治的129例慢性胃炎患者为研究对象,根据病理诊断结果将其分为CAG组(56例)和慢性浅表性胃炎(chronic superficial gastritis,CSG)组(73例),分析NBI-ME联合血清指标[胃蛋白酶原Ⅰ(pepsinogen Ⅰ,PGⅠ)、胃蛋白酶原Ⅱ(pepsinogen Ⅱ,PGⅡ)、PGⅠ/PGⅡ比值(PGR)、胃泌素-17(gastrin-17,G-17)]检测对CAG的诊断效能。结果以病理诊断为金标准,NBI-ME诊断CAG的灵敏度为80.36%(45/56)、特异度为79.45%(58/73)、阳性预测值为75.00%(45/60)、阴性预测值为84.06%(58/69)、诊断准确率为79.84%(103/129)。CAG组患者PGⅠ、G-17水平和PGR均显著低于CSG组(均P<0.05),两组患者PGⅡ水平比较差异无统计学意义(P>0.05)。血清指标检测诊断CAG的灵敏度为75.00%(42/56)、特异度为78.08%(57/73)、阳性预测值为72.41%(42/58)、阴性预测值为80.28%(57/71)、诊断准确率为76.74%(99/129)。NBI-ME联合血清指标检测诊断CAG的特异度、阳性预测值和准确率均显著高于NBI-ME和血清指标检测单独诊断(均P<0.05)。结论NBI-ME联合血清指标检测可以有效提高CAG的临床诊断准确率,有利于筛查早期胃癌高风险人群,降低胃癌发病率。Objective To explore the diagnostic value of narrow band imaging-magnifying endoscopy (NBI-ME) combined with serum indexes detection in the diagnosis of chronic atrophic gastritis (CAG).Method 129 patients with chronic gastritis admitted to the Affiliated Hospital of Qingdao University from September 2018 to October 2019 were selected as the research objects,and they were divided into CAG group (56 cases) and chronic superficial gastritis (CSG) group (73 cases) according to pathological diagnosis results,the diagnostic efficacy of NBI-ME combined with serum index [pepsinogen Ⅰ(PGⅠ),pepsinogen Ⅱ (PGⅡ),PGⅠto PGⅡ ratio (PGR),gastrin-17 (G-17)] detection for CAG were analyzed.Result Taking pathological diagnosis as the gold standard,the sensitivity of NBI-ME for diagnose of CAG was 80.36% (45/56),specificity was 79.45% (58/73),positive predictive value was 75.00% (45/60),negative predictive value was 84.06% (58/69),the diagnostic accuracy rate was 79.84% (103/129).The levels of PGⅠ,G-17 and PGR in CAG group were significantly lower than those in CSG group (all P<0.05),there was no significant difference in PGⅡ level between the two groups (P>0.05).The sensitivity of serum indexes detection for diagnose of CAG was 75.00% (42/56),specificity was 78.08% (57/73),positive predictive value was 72.41% (42/58),negative predictive value was 80.28% (57/71),the diagnostic accuracy rate was 76.74% (99/129).The specificity,positive predictive value and diagnostic accuracy of NBI-ME combined with serum indexes detection in the diagnosis of CAG were significantly higher than those of NBI-ME and serum indexes detection alone (all P<0.05).Conclusion The detection of NBI-ME combined with serum indexes detection can effectively improve the accuracy of clinical diagnosis of CAG,it is helpful to screen people at high risk of early gastric cancer,and reduce the incidence of gastric cancer.

关 键 词：窄带成像放大内镜检查 胃蛋白酶原 胃泌素 诊断 

分 类 号：R573.32[医药卫生—消化系统]