摘要
目的 探讨放大内镜对慢性萎缩性胃炎 (CAG)的诊断价值。方法 采用前瞻性研究方法 ,应用OlympusGpQ - 2 4 0Z新型电子放大内镜对 12 0例不同慢性胃炎患者的胃黏膜微细结构形态进行仔细观察 ,并实时作出放大内镜诊断 ,然后在放大观察区取活检送病理检查 ,以验证放大内镜诊断的准确性。结果 放大内镜将慢性胃炎分为三型 :Ⅰ型 :为浅表性胃炎的代表 ,表现为小凹呈短小棒状或圆点状规则性分布 ,常可见小凹开口模糊、散在红斑 ;Ⅱ型 :多为轻度CAG ,表现为部分区域小凹轮廓模糊、结构稍紊乱 ,可见点状、线状小凹稀疏消失区 ;Ⅲ型 :多为中重度CAG ,表现为大面积出现小凹消失形成的片状、条带状疤痕样改变 ,或出现由于小凹延长、扩张、排列紊乱或肠化所形成的树枝样或绒毛状改变。该组资料放大内镜和普通内镜对CAG诊断的敏感度分别为 89.3%和 4 2 .9% (P <0 .0 5 )、特异度分别为 89.1%和 82 .8% (P >0 .0 5 ) ,准确度分别为 89.2 %和 6 4 .2 % (P <0 .0 5 )。结论 放大内镜诊断CAG在敏感性和准确性方面较普通内镜有明显的优势 ,可不等待活检病理结果直接作出较准确的实时内镜诊断。
Objective:To explore the diagnostic value of magnifying endoscopy in chronic atrophic gastritis (CAG).Methods: With a prospective investigation method,microstructures of gastric mucosa in 120 patients with different chronic gastritis were studied using Olympus GIF-Q240Z magnifying endoscope. Endoscopic diagnosis was made at real time. Biopsies were then taken from the magnified sites to check the accuracy of the diagonsis.Results: Under magnifying endoscopy,chronic gastritis were classfied into three types: Type I:representative of superficial gastritis,with characteristics of regularly distributed round-spot or short-rod gastric pits;Type Ⅱ:main being mild CAG,with appearance of unclear,irregular pits and dot- or line-like areas with disappeared pits in dispersed localized regions;Type Ⅲ:mainly being moderate and severe CAG,with appearances of piece or strap scar-like changes without gastric pits in larger regions ,or branched,villus-like pits due to dilated,prolonged and irregularly distributed pits or intestinal metaplasia. The results revealed that sensitivity,specificity and accuracy of magnifying endoscopy and routine endoscopy in the diagnosis of CAG were 89.3% and 42.9%( P <0.05);89.1% and 82.8%( P >0.05);89.2% and 64.2%( P <0.05) respectively. Conclusions: In the diagnosis of CAG,magnifying endoscopy is superior to routine endoscopy in its sensitivity and accuracy and real time endoscopic diagnosis can be exactly made without biopsy results.
出处
《中国内镜杂志》
CSCD
2004年第2期41-44,共4页
China Journal of Endoscopy
关键词
放大内镜检查
慢性萎缩性胃炎
胃黏膜病变
magnifying endoscopy
chronic atrophic gastritis
gastric mucosal lesion
