中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2012年
4期
217-221
,共5页
胡靥%Eugene You Hao Chooi%陈晓宇%戈之铮%房静远
鬍靨%Eugene You Hao Chooi%陳曉宇%戈之錚%房靜遠
호엽%Eugene You Hao Chooi%진효우%과지쟁%방정원
螺杆菌,幽门%胃炎,萎缩性%内窥镜检查%活组织检查
螺桿菌,幽門%胃炎,萎縮性%內窺鏡檢查%活組織檢查
라간균,유문%위염,위축성%내규경검사%활조직검사
Helicobacter pylori%Gastritis,atrophic%Endoscopy%Biopsy
目的 探讨各种因素对内镜医师诊断慢性萎缩性胃炎(CAG)准确性的影响.方法 采用回顾性分析的方法,收集上海交通大学医学院附属仁济医院2009年1月至12月间行内镜检查的10 765例慢性胃炎患者,分析内镜下充血渗出、糜烂、胃溃疡、胆汁反流、胃息肉病例及幽门螺杆菌(Hp)感染对CAG内镜及病理诊断的影响.结果 病理检查CAG的诊断率为69.41％,内镜检查CAG的诊断率为54.27％,两者符合率为62.30％.Hp阳性者2575例(23.92％),Hp阳性者的CAG内镜和病理诊断符合率是Hp阴性者的90％(β=0.1067,P＜0.05).年龄和符合率成正相关.年龄每增加1岁,内镜和病理诊断符合率增加了0.01倍[OR=exp(0.00855)=1.01];每增加10岁符合率增加了0.09倍[OR=exp(0.0855)=1.09].胃黏膜充血渗出和符合率成负相关.有充血渗出者的CAG内镜和病理诊断符合率是无充血渗出者的40％(β=-0.9044,P＜0.01).结论 内镜下对CAG的判断有一定主观性,需结合病理分析方可确诊.患者年龄、Hp感染、内镜下充血渗出会影响CAG的内镜和病理诊断的符合率.
目的 探討各種因素對內鏡醫師診斷慢性萎縮性胃炎(CAG)準確性的影響.方法 採用迴顧性分析的方法,收集上海交通大學醫學院附屬仁濟醫院2009年1月至12月間行內鏡檢查的10 765例慢性胃炎患者,分析內鏡下充血滲齣、糜爛、胃潰瘍、膽汁反流、胃息肉病例及幽門螺桿菌(Hp)感染對CAG內鏡及病理診斷的影響.結果 病理檢查CAG的診斷率為69.41％,內鏡檢查CAG的診斷率為54.27％,兩者符閤率為62.30％.Hp暘性者2575例(23.92％),Hp暘性者的CAG內鏡和病理診斷符閤率是Hp陰性者的90％(β=0.1067,P＜0.05).年齡和符閤率成正相關.年齡每增加1歲,內鏡和病理診斷符閤率增加瞭0.01倍[OR=exp(0.00855)=1.01];每增加10歲符閤率增加瞭0.09倍[OR=exp(0.0855)=1.09].胃黏膜充血滲齣和符閤率成負相關.有充血滲齣者的CAG內鏡和病理診斷符閤率是無充血滲齣者的40％(β=-0.9044,P＜0.01).結論 內鏡下對CAG的判斷有一定主觀性,需結閤病理分析方可確診.患者年齡、Hp感染、內鏡下充血滲齣會影響CAG的內鏡和病理診斷的符閤率.
목적 탐토각충인소대내경의사진단만성위축성위염(CAG)준학성적영향.방법 채용회고성분석적방법,수집상해교통대학의학원부속인제의원2009년1월지12월간행내경검사적10 765례만성위염환자,분석내경하충혈삼출、미란、위궤양、담즙반류、위식육병례급유문라간균(Hp)감염대CAG내경급병리진단적영향.결과 병리검사CAG적진단솔위69.41％,내경검사CAG적진단솔위54.27％,량자부합솔위62.30％.Hp양성자2575례(23.92％),Hp양성자적CAG내경화병리진단부합솔시Hp음성자적90％(β=0.1067,P＜0.05).년령화부합솔성정상관.년령매증가1세,내경화병리진단부합솔증가료0.01배[OR=exp(0.00855)=1.01];매증가10세부합솔증가료0.09배[OR=exp(0.0855)=1.09].위점막충혈삼출화부합솔성부상관.유충혈삼출자적CAG내경화병리진단부합솔시무충혈삼출자적40％(β=-0.9044,P＜0.01).결론 내경하대CAG적판단유일정주관성,수결합병리분석방가학진.환자년령、Hp감염、내경하충혈삼출회영향CAG적내경화병리진단적부합솔.
Objective To investigate the related factors which influencing endoscopists in the accuracy of diagnosis of chronic atrophic gastritis (CAG). Methods With retrospective analysis method,from January to December in 2009,10 765 chronic gastritis cases underwent endoscopy examination in Renji Hospital,school of medicine,Shanghai Jiaotong University were collected.The influence of congestion and exudation,gastric ulcer,bile reflux,gastric polyps and H.pylori infection under endoscopy on CAG endoscopic and pathological diagnosis was analyzed.Results The percentage of histopathological diagnosed CAG was 69.41％,endoscopic diagnosed CAG was 54.27％. The coincidence rate was 62.30％.2575 cases were H.pylori positive (23.92％),the coincidence rate between endoscopic and histopathological diagnosis in H.pylori positivc cascs was 90％.of that of H.pylori negative cases (β=-0.1067,P＜0.05).The coincidence was positively related to age.For each 1 year increase in age,the coincidence rate increased by 0.01 time [OR=exp(0.00855)=1.01]; For each 10-year increase in age,the coincidence rate increased by 0.09 time [OR=exp(0.0855) =1.09].The coincidence rate was negatively related to congestion and exudation.The coincidence rate of CAG between endoscopic and histopathological diagnosis in cases with congestion and exudation was 40％ of that without congestion and exudation (β=-0.1067,P＜0.01).Conclusion CAG diagnosed under endoscopy was somewhat subjective and should be combined with histopathological analysis.The patients' age,H.pylori infection,congestion and exudation may have influence on the coincidence rate between endoscopic and histopathological diagnosis of CAG.
