基于NBI的慢性胃炎木村-竹本分类与OLGIM系统相关性研究  

Research on the correlation between Kimura-Takemoto classification of chronic gastritis and OLGIM system based on NBI

作　　者：石亮宇 施萍[1] 高度思 吴南飞 高莹昕 SHI Liangyu;SHI Ping;GAO Dusi;WU Nanfei;GAO Yingxin(Department of Gastroenterology,the People’s Hospital of Tongcheng,Anhui,Tongcheng 231400,China)

机构地区：[1]安徽省桐城市人民医院消化内科,安徽桐城231400

出　　处：《中国医药科学》2025年第7期115-118,共4页China Medicine And Pharmacy

基　　金：消化道早癌医师共同成长计划科研项目(GTCZ-2021-AH-34-0007)。

摘　　要：目的探讨基于窄带成像内镜(NBI)的慢性胃炎木村-竹本分类法与以肠化生替代萎缩的分期标准(OLGIM)在慢性胃炎的评估中的作用和相关性,实现通过木村-竹本分类法在内镜下对慢性胃炎快速诊断。方法随机纳入桐城市人民医院内镜中心2023年4—8月行胃镜检查且镜下评估为慢性胃炎的82例患者进行研究,根据NBI表现并进行木村-竹本分类,精准进行活检,再对照OLGIM系统,分析基于NBI的慢性胃炎的两种分类系统的一致性。结果基于NBI的慢性胃炎木村-竹本分类法与OLGIM系统共有42例诊断结果一致,占51.22%(42/82),内镜下木村-竹本分类与病理组织学OLGIM系统分级两种评估系统呈中度相关性(R=0.540,P<0.001)和中度一致性(Kappa=0.432,P<0.001),多因素logistic回归分析提示幽门螺杆菌感染是影响两种诊断系统一致性的唯一独立危险因素(OR=2.955,95%CI:1.150~7.592,P<0.05)。结论基于NBI的慢性胃炎木村-竹本分类法与OLGIM系统在评估慢性胃炎中具有相关性,有助于识别胃黏膜萎缩和胃黏膜肠上皮化生,并可避免或者减少活检次数。Objective To investigate the role and correlation of Kimura-Takemoto classification of chronic gastritis based on narrow band imaging endoscopy(NBI)and staging standard of operative link on gastric intestinal metaplasia(OLGIM)in the evaluation of chronic gastritis,and realize the rapid diagnosis of chronic gastritis under endoscope through Kimura-Takemoto classification.Methods A total of 82 patients who were randomly included in the Endoscopy Center of the People’s Hospital of Tongcheng and were diagnosed as chronic gastritis under the gastroscopy from April to August 2023 were studied.According to NBI performance,Kimura-Takemoto classification was conducted,and biopsy was performed accurately.Then,compared with OLGIM system,the consistency of the two classification systems of chronic gastritis based on NBI was analyzed.Results There were totally 42 cases of chronic gastritis diagnosed by Kimura-Takemoto classification and OLGIM system based on NBI,accounting for 51.22%(42/82).The two evaluation syst ems,Kimura-Takemoto classification under endoscope and OLGIM system classification of pathology,had moderate correlation(R=0.540,P<0.001)and moderate consistency(Kappa=0.432,P<0.001).Multivariate logistic regression analysis showed that Helicobacter pylori infection was the only independent risk factor affecting the consistency of the two diagnostic systems(OR=2.955,95%CI:1.150-7.592,P<0.05).Conclusion The Kimura-Takemoto classification of chronic gastritis based on NBI is correlated to OLGIM system in evaluating chronic gastritis,which is helpful in identifying gastric mucosal atrophy and intestinal metaplasia of gastric mucosa,and can av oid or reduce the number of biopsies.

关 键 词：窄带成像内镜 慢性胃炎 以肠化生替代萎缩的分期标准 肠上皮化生 木村-竹本分类 

分 类 号：R573.3[医药卫生—消化系统]