木村-竹本分类法对胃镜检查中胃黏膜萎缩情况判断的价值研究  

A study on the practical value of Kimura-Takemoto classification in judging the atrophy of gastric mucosa during gastroscopy

作　　者：孙倩[1] SUN Qian(Department of Gastroenterology,Anshun People’s Hospital,Anshun 561000,China)

机构地区：[1]安顺市人民医院消化内镜科,贵州安顺561000

出　　处：《中国中西医结合消化杂志》2020年第11期867-870,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]探讨木村-竹本分类法对胃镜检查胃黏膜萎缩情况判断的实用价值。[方法]选取2019年5月~12月行胃镜检查的120例患者为调查对象,均先行木村-竹本分类法评估患者胃黏膜萎缩情况,后按照新悉尼系统活检取材标准进行活检取材,再按照OLGA评估系统进行分期,比较木村-竹本分类法与OLGA评估系统诊断结果的一致性。[结果]木村-竹本分类法与OLGA系统评估结果具有中等相关性(r=0.182,P=0.046),2种评估方法对慢性胃炎分期诊断结果上有中等一致性(Kappa=0.437,P=0.042)。多因素Logistic分析表明,吸烟、Hp感染、服用非甾体类消炎药是影响2种评估方法一致性的因素,排除影响因素后,木村-竹本分类法与OLGA系统具有高度的相关性(r=0.732,P=0.000)。二者对慢性胃炎诊断结果也具有高度的一致性(Kappa=0.685,P=0.000)。[结论]木村-竹本分类法与OLGA系统在评估慢性萎缩性胃炎中具有明显的相关性,在临床实践中可采用木村-竹本分类法对患者进行胃癌风险预测。[Objective]To explore the practical value of Kimura-Takemoto classification and gastroscopy in judging the atrophy of gastric mucosa.[Methods]One hundred and twenty patients who underwent gastroscopy from May to December 2019 were selected as the objects of investigation.All the patients were evaluated by Kimura-Takemoto classification,then by biopsy according to the new Sydney system,and then by stages according to the OLGA evaluation system.The consistency of diagnosis results between Kimura-Takemoto classification and OLGA evaluation system was compared.[Results]There was a moderate correlation between the results of OLGA and Kimura-Takemoto classification(r=0.182,P=0.046).There was a moderate consistency between the two systems in the diagnosis of chronic gastritis(Kappa=0.437,P=0.042).Multivariate logistic analysis showed that smoking,Hp infection and nonsteroidal antiinflammatory drugs were the factors influencing the consistency of the two evaluation systems.After the factors were excluded,Kimura-Takemoto classification was highly correlated with OLGA system(r=0.732,P=0.000).The results of diagnosis of chronic gastritis were also highly consistent(Kappa=0.685,P=0.000).[Conclusion]There is a significant correlation between Kimura-Takemoto classification and OLGA system in the assessment of chronic atrophic gastritis.In clinical practice,Kimura-Takemoto classification can be used to predict the risk of gastric cancer in patients.

关 键 词：木村-竹本分类法 胃镜 萎缩 胃黏膜 OLGA系统 

分 类 号：R573[医药卫生—消化系统]