^(13)C尿素呼气试验检测值的判读价值

Prognostic value of ^(13)C-urea breath test

目的探讨^(13)C尿素呼气试验(^(13)C-UBT)检测值的判读价值。方法选取于我院行胃镜检查并取活检的患者257例,根据^(13)C-UBT结果(DOB值)将其分为1组(0≤DOB<4)95例、2组(4≤DOB<8)31例、3组(8≤DOB<20)49例、4组(20≤DOB<40)48例、5组(DOB≥40)34例。1组为Hp阴性患者(0≤DOB<4,Hp阴性组,95例),2~5组为Hp阳性患者(DOB≥4,Hp阳性组,162例)。比较各组患者临床、内镜、病理特点的差异。结果不同DOB值各组之间消化道症状大多差异无统计学意义。Hp阳性组患者镜下非萎缩性胃炎炎症分级的严重程度高于阴性组,且镜下胃炎的严重程度随DOB值升高而加重(P<0.05);而各组萎缩性胃炎分级分布情况比较差异无统计学意义(P>0.05)。Hp阳性组患者胃黏膜组织学急、慢性炎症的程度均高于阴性组,且组织学炎症程度随DOB值升高增加(P<0.05);各组患者胃黏膜萎缩、肠化的程度比较差异无统计学意义(P>0.05)。DOB值越高,胃黏膜Hp密度越高(P<0.05)。结论Hp感染后症状不典型,DOB值与胃内Hp密度、胃黏膜的炎症程度呈正相关,但不能预测胃黏膜萎缩及肠化的程度。

Objective To study the prognostic value of^(13)C-urea breath test(^(13)C-UBT).Methods A total of 257 patients who underwent gastroscopy and biopsy were enrolled.According to^(13)C-UBT results(DOB value),they were divided into group 1(0≤DOB<4,95 cases),group 2(4≤DOB<8,31 cases),group 3(8≤DOB<20,49 cases),group 4(20≤DOB<40,48 cases)and group 5(DOB≥40,34 cases).Group 1 was Hp-negative patients(0≤DOB<4,Hp-negative group,95 cases),and groups 2-5 were Hp-positive patients(DOB≥4,Hp-positive group,162 cases).The differences of symptoms,endoscopic manifestations,tissue inflammation and atrophy among groups were compared.Results There were almost no differences in symptoms among groups with different DOB values.The severity of inflammation grade of non-atrophic gastritis in Hp-positive group was higher than that in Hp-negative group,and the severity of gastritis increased with the increase of DOB value(P<0.05).There was no significant difference in the grading distribution of atrophic gastritis among all groups(P>0.05).The degree of acute and chronic inflammation of gastric mucosa in Hp-positive group was higher than that of Hp-negative group,and the degree of inflammation increased with the increase of DOB value(P<0.05).There was no significant difference in the degree of gastric mucosa atrophy and intestinal metaplasia among groups(P>0.05).The Hp bacteria density was higher in patients with higher DOB value(P<0.05).Conclusion The symptoms of Hp infection were atypical.The DOB value could indicate the density of Hp and reflect the degree of gastric inflammation,but could not predict the degree of gastric mucosa atrophy and intestinal metaplasia.