胃镜下酚红染色对幽门螺杆菌感染的诊断价值  

Diagnostic value of gastroscopic phenol red staining for Helicobacter pylori infection

作　　者：郝科欣 万新月[1] 邓涛[1] HAO Kexin;WAN Xinyue;DENG Tao(Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060

出　　处：《胃肠病学和肝病学杂志》2022年第9期985-989,共5页Chinese Journal of Gastroenterology and Hepatology

基　　金：中国肝炎防治基金会天晴肝病研究基金(KY-QT-2017-01)。

摘　　要：目的评价胃镜下酚红染色技术在幽门螺杆菌(Helicobacter pylori,H.pylori)感染诊断中的价值。方法选取2021年5月至2022年5月在武汉大学人民医院同时行酚红染色试验、碳13-尿素呼气试验(^(13)C-UBT)及组织病理学检查的110例患者纳入研究。以免疫组化为金标准,采用Kappa一致性检验评价酚红染色、^(13)C-UBT与免疫组化结果的一致性。采用χ2检验评价组织病理学的悉尼评分与H.pylori感染的相关性。结果胃镜下酚红染色诊断H.pylori感染的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为84.0%(42/50)、86.7%(52/60)、84.0%(42/50)、86.7%(52/60)、85.5%(94/110)。胃镜下酚红染色与免疫组化结果的一致性较好(Kappa=0.707,P<0.001);^(13)C-UBT诊断H.pylori感染的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为78.0%(39/50)、90.0%(54/60)、86.7%(39/45)、83.1%(54/65)、84.5%(93/110),^(13)C-UBT诊断H.pylori与免疫组化结果的一致性较好(Kappa=0.662,P<0.001)。染色模式评分与Δ^(13)C-UBT呈中度正相关(r=0.78,P<0.001)。H.pylori感染与中性粒细胞浸润、慢性炎症和萎缩有相关性(P<0.05)。结论胃镜下酚红染色是一种诊断H.pylori感染的敏感、相对特异、快速、安全和低成本的有效方法,尤其适用于有活检禁忌患者的病例,即使是经验欠缺的内镜医师也可以快速诊断。Objective To evaluate the value of the gastroscopic phenol staining test in the diagnosis of Helicobacter pylori(H.pylori)infection.Methods 110 patients who underwent gastroscopic phenol red staining test,^(13)C-UBT,and histopathological examination at the same time in Renmin Hospital of Wuhan University from May 2021 to May 2022 were enrolled in this study.Taking immunohistochemistry as the gold standard,the consistency among phenol red staining,^(13)C-UBT,and immunohistochemical results was evaluated using Kappa test,and the correlation between Sydney score of histopathology and H.pylori infection was evaluated using Chi-square test.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of gastroscopic phenol red staining for the diagnosis of H.pylori were 84.0%(42/50),86.7%(52/60),84.0%(42/50),86.7%(52/60),and 85.5%(94/110),respectively.The consistency between gastroscopic phenol red staining and immunohistochemical findings(Kappa=0.707,P<0.001).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of^(13)C-UBT for the diagnosis of H.pylori were 78.0%(39/50),90.0%(54/60),86.7%(39/45),83.1%(54/65)and 84.5%(93/110),respectively,with good consistency between^(13)C-UBT and immunohistochemical findings(Kappa=0.662,P<0.001).There was a moderate positive correlation between the staining pattern score andΔ^(13)C-UBT(r=0.78,P<0.001).H.pylori infection was statistically correlated with neutrophil infiltration,chronic inflammation and atrophy(P<0.05).Conclusion Gastroscopic phenol red staining test is a sensitive,relatively specific,rapid,safe,and cost-effective method for the diagnosis of H.pylori infection,especially in cases where biopsy is contraindicated in patients,allowing rapid diagnosis even inexperienced endoscopists.

关 键 词：幽门螺杆菌 诊断 酚红 尿素呼气试验 

分 类 号：R378[医药卫生—病原生物学]