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[目的]探讨放大内镜结合窄带成像技术(narrow-bandimaging magnification endoscopy,NBI-ME)在幽门螺旋杆菌(Helicobacter pylori,Hp)相关性胃炎中的诊断价值。[方法]选取360例在普通内镜下提示慢性胃炎的患者,行(14)~C呼气试验检测,并在NBI-ME下仔细观察胃窦部胃小凹形态和胃体下部大弯侧集合静脉形态,分析胃黏膜微细结构与Hp感染之间的联系。[结果]360例中有148例经(14)~C呼气试验检测诊断为Hp相关性胃炎。胃窦部大弯侧胃小凹形态分为B型、C型、D型、E型,Hp感染率分别是22.51%、83.63%、28.94%、9.52%,C型感染率最高,与B型、D型、E型比较均差异有统计学意义(P<0.05),B型、D型、E型间比较差异无统计学意义;经抗Hp治疗后B型由治疗前的43例增加为治疗后的125例,而C型、D型和E型则分别减少74例、7例、1例,C型减少最多;B型、C型、D型、E型抗Hp有效率分别为55.41%、80.43%、63.64%、50.00%,C型有效率最高,与其他各型比较差异有统计学意义(P<0.05)。胃体下部大弯侧集合静脉分为R型、I型、D型,Hp感染率分别为6.81%、62.22%、86.29%,其中D型、I型感染率明显高于R型(P<0.05);经抗Hp治疗后R型由治疗前的13例增加为治疗后的119例,而I型、D型则分别减少17例、89例,D型减少最多;R型、I型、D型抗Hp有效率分别为71.62%、60.71%、83.18%,D型有效率最高,与R型、I型比较差异有统计学意义(P<0.05)。[结论]NBI-ME能够清楚观察胃黏膜的细微结构及血管形态,从而对Hp相关性胃炎有较高的诊断价值。
[Objective] To investigate the diagnostic value of narrow-band imaging magnification endoscopy (NBI-ME) in Helicobacter pylori (Hp) -related gastritis. [Methods] A total of 360 patients with chronic gastritis suggested by ordinary endoscopy were examined by breath test (14) ~ C. The morphology of gastric pits and the lesser curvature on the lower part of gastric body were observed under NBI-ME Venous morphology was collected to analyze the relationship between microscopic structure of gastric mucosa and Hp infection. [Results] 148 of 360 cases were diagnosed as Hp-related gastritis by (14) ~ C breath test. The gastric lesion on the greater curvature side of gastric antrum was divided into B, C, D, E and Hp infection rates of 22.51%, 83.63%, 28.94% and 9.52% respectively. The infection rate of type C was the highest, (P <0.05). There was no significant difference between B type, D type and E type. After anti-Hp treatment, B type increased from 43 cases before treatment to After treatment, there were 125 cases in C group, D type and E type, while the reduction in C type was 74 cases, 7 cases and 1 case, respectively. The effective rate of C type, C type, D type and E type anti-Hp were 55.41 %, 80.43%, 63.64% and 50.00%, respectively. The highest effective rate of C type was found, and the difference was statistically significant compared with other types (P <0.05). The infection rate of type R, type I, type D and type H were 6.81%, 62.22% and 86.29%, respectively. The infection rate of type D and type I was significantly higher than that of type R (P <0.05) ). After anti-Hp therapy, R type increased from 13 cases before treatment to 119 cases after treatment, while 17 cases and 89 cases decreased in type I and type D, respectively, with the largest decrease in type D; type R, type I, type D Type anti-Hp effective rates were 71.62%, 60.71%, 83.18%, D type the highest efficiency, and R type, I type difference was statistically significant (P <0.05). [Conclusion] The NBI-ME can clearly observe the microstructure and morphology of gastric mucosa, which has a high diagnostic value for Hp-related gastritis.