放大电子胃镜对幽门螺杆菌相关性胃炎的诊断.docVIP

放大电子胃镜对幽门螺杆菌相关性胃炎的诊断 年维东、张齐联、梁进雨，尹洪芳*??北京大学第一医院外科，病理科* ??????[摘要] 目的：研究放大电子胃镜对正常胃粘膜及幽门螺杆菌相关性胃炎的诊断价值。方法：总结66例接受放大电子胃镜检查的患者，观察胃体黏膜毛细血管网、胃小凹及集合小静脉的变化，同时取活检行病理检查及进行Hp检测。结果 66个病人中HP阳性者为36例，阴性者为30例。HP阳性者中正常胃粘膜者2例，炎症者34例；HP阴性者中，正常胃粘膜者28例，炎症者2例。HP阳性者中，Z0为3例，Z1为8例，Z2为15例，Z3为10例；HP阴性者中，Z0为27例，Z1为1例，Z2为2例，Z3为0例。结论 电子放大胃镜下观察到的胃体黏膜集合小静脉、毛细血管网、胃小凹是正常胃粘膜的特征，而它们的消失与变化是HP相关性胃炎的特征。 ??????[关键词] 放大电子胃镜；Hp相关性胃炎? The efficacy of magnifying endoscopy for diagnosis of Helicobacter pylori-induced gastritis? Nian Wei-dong, Zhang Qi-ling, Liang Jin-yu et al. Department of Surgery, Beijing University First Hospital, Beijing 100034, China [Abstract] Objective:To evaluate the efficacy of magnifying endoscopy for diagnosis of Helicobacter pylori-induced gastritis. Methods?The anterior wall or greater curvature of the middle body of the stomachs of 66 patients were observed by magnifying endoscopy. Forceps biopsy was performed at the following locations: 1. the magnified site, for histological examination; 2. the antral mucosa, for urease test, and histology.?Results:?28 patients were diagnosed as having Hp-negative normal stomach and 34 as having Hp-positive gastritis. The magnified views were classified into four types: 1.collecting venules, with true capillaries forming a network, and gastric pits resembling pinholes (type Z-0; n=30); 2. irregular true capillaries but no collecting venules observed (type Z-1; n=9); 3. white gastric pits , with neither collecting venules nor true capillaries being seen (Z-2; n=17); 4. dilated pits with surrounding redness (Z-3; n=10).?Conclusions:?Collecting venules and true capillaries forming a network with gastric pits in the center (type Z-0) were characters of the Hp-negative normal mucosa. [Key words]?Magnified endoscopy; Hp-related gastritis?牋牋牋已有充分证据证明，幽门螺杆菌是慢性胃炎的主要病因。自悉尼系统（1990年）及新悉尼胃炎分类系统（1996年）[1]公布以来，已有很多文献对其实用性进行讨论。2000年我国在井冈山举行的慢性胃炎研讨会上也进行了慢性胃炎的分类[2]。但以上分类都未能解决胃镜下单独诊断幽门螺杆菌相关性胃炎的问题。怎样使胃镜下的诊断与病理组织学的诊断相吻合，是一个急待解决的问题。 ??????放大电子胃镜（GIF-Q24