蓝激光内镜联动成像模式在幽门螺杆菌感染诊断中的应用价值  

Application value of blue laser endoscopy with linked color imaging mode in the diagnosis of Helicobacter pylori infection

作　　者：陈佩[1] 方立峰[1] 王志永[1] 吕晓芳[1] 王东芳[1] CHEN Pei;FANG Lifeng;WANG Zhiyong;LYU Xiaofang;WANG Dongfang(Department of Gastroenterology,Zhengzhou First People′s Hospital,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州市第一人民医院消化内科,河南郑州450000

出　　处：《新乡医学院学报》2022年第9期851-854,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨蓝激光内镜联动成像(LCI)模式对幽门螺杆菌(Hp)感染的诊断价值。方法选择2020年6月至2021年6月于郑州市第一人民医院经胃镜检查疑诊为Hp感染的100例患者为研究对象。所有患者行^(13)碳尿素呼气试验(^(13)C-UBT),并以^(13)C-UBT超基准值≥4作为判断Hp感染的阳性标准。所有患者行消化系统蓝激光内镜LCI模式检查,采用白光检查模式依次观察食管、胃、十二指肠,然后切换LCI模式,依次观察胃窦、胃窦体交界处、胃体及胃底,观察到有异常发红或淡紫色区域即为Hp感染阳性。取蓝激光内镜LCI模式检查发红或淡紫色区域组织进行组织病理学检测,并以组织病理学检测结果为诊断Hp感染的金标准。采用Kappa分析检验蓝激光内镜LCI模式、^(13)C-UBT与组织病理学诊断结果的一致性。结果蓝激光内镜LCI模式检查、^(13)C-UBT检查诊断Hp感染的准确率均为97.0%。蓝激光内镜LCI模式诊断Hp感染的敏感度、特异度、阳性预测值、阴性预测值分别为100.00%、90.63%、95.77%、100.00%,^(13)C-UBT诊断Hp感染的敏感度、特异度、阳性预测值、阴性预测值分别为97.06%、96.88%、98.81%、93.94%;蓝激光内镜LCI模式与^(13)C-UBT诊断Hp感染的敏感度、特异度、阳性预测值、阴性预测值比较差异无统计学意义(χ^(2)=2.030、1.067、0.915、1.816,P>0.05)。Kappa分析结果显示,蓝激光内镜LCI模式、^(13)C-UBT与组织病理学诊断结果具有显著一致性(Kappa=0.764、0.751,P<0.05)。结论蓝激光内镜LCI模式诊断Hp感染的准确度、敏感度、特异度较高,为临床辅助判断Hp感染提供了新的诊断方法。Objective To explore the application value of blue laser endoscopic with linked color imaging(LCI)in the diagnosis of Helicobacter pylori(Hp)infection.Methods A total of 100 patients suspected of Hp infection by gastroscopic examination in Zhengzhou First People′s Hospital from June 2020 to June 2021 were selected as the research subjects.All patients underwent ^(13)carbon urea breath test(^(13)C-UBT),and ^(13)C-UBT delta over baseline value≥4 was used as the positive standard for judging Hp infection.All patients underwent blue laser endoscopy with LCI mode examination of digestive system.The esophagus,stomach and duodenum were observed in white light inspection mode in turn,and then the LCI mode was switched to observe the gastric antrum,the junction of the gastric antrum body,the gastric body and the gastric fundus in turn;an abnormally red or lavender area was observed to be positive for Hp infection in the gastric mucosa.The tissue in the red or lavender area was examined by blue laser endoscopy with LCI mode for histopathological examination,and the result of histopathological examination was used as the gold standard for diagnosing Hp infection.The consistency of blue laser endoscopic with LCI mode,^(13)C-UBT and histopathological diagnosis results was detected by Kappa analysis.Results The diagnostic accuracy rates of blue laser endoscopy with LCI mode and ^(13)C-UBT inspection were both 97.0%.The sensitivity,specificity,positive predictive value and negative predictive value of blue laser endoscopic with LCI mode in the diagnosis of Hp infection were 100.00%,90.63%,95.77%and 100.00%,respectively;the sensitivity,specificity,positive predictive value and negative predictive value of ^(13)C-UBT in the diagnosis of Hp infection were 97.06%,96.88%,98.51%and 93.94%,respectively.There was no significant difference in the sensitivity,specificity,positive predictive value and negative predictive value between the blue laser endoscopy with LCI mode and ^(13)C-UBT in the diagnosis of Hp infection(χ^(2)=2.030,1

关 键 词：幽门螺杆菌 蓝激光内镜 联动成像 临床诊断 

分 类 号：R181.32[医药卫生—流行病学]