胃窦黏膜粗糙不平不同表现对慢性萎缩性胃炎的诊断价值

The diagnostic value of the different manifestation of gastric antrum mucosa's roughness in chronic atrophic gastritis

目的探讨胃窦黏膜粗糙不平不同表现对慢性萎缩性胃炎(CAG)的诊断价值。方法选择胃镜下胃窦黏膜粗糙不平不同表现的患者118例,分均匀粗糙和非均匀粗糙两组。均匀粗糙分砂纸状、鳞片状及粗结节状3型,非均匀粗糙分细小、中等、粗大结节状3级。每组分有灰白凹陷和无灰白凹陷两型。比较粗糙不同表现处、灰白凹陷处的病理性质。结果非均匀粗糙对粗糙不平黏膜萎缩性炎症的灵敏度是96.8%,特异度是85.7%,和均匀粗糙比较差异有显著性。非均匀粗糙程度与病理萎缩程度有相关性。胃窦黏膜均匀粗糙灰白凹陷处与非均匀粗糙及其灰白凹陷处比较差别无显著性。结论胃窦黏膜粗糙不平的均匀性可作为慢性胃炎萎缩性和非萎缩性的判断依据;黏膜粗糙伴灰白凹陷者不论占比多少,胃镜诊断应以白区为准;胃镜下黏膜粗糙程度分级有临床意义。

[Objective] To investigate the diagnostic value of the different manifestation of gastric antrum mucosa ＇s roughness in chronic atrophic gastritis（CAG）.[Methods] 118 cases of rough sinuses ventricular heterophany under view of gastro-scope were divided into two groups of uniform rough and non-uniform rough in accordance with the distribution and size uniformity of mucosa surface protuberance;and furthermore,the uniform rough type was divided into three sub-types of sand paper like,scaly like and thick tubercle,and the non-uniform rough type was classified into three grades of fine,medium and thick.Subsequently,these two groups were generalized into off-white dent type and off-white dent free type,and then was verified of pathological characteristics of rough heterophany distribution and off-white dent distribution.[Results] Sensitivity percentage of non uniform roughness against rough mucosa CAG is 96.8%,and specificity percentage of that is 85.7%.The non uniform roughness extent is related to that of pathological atrophy.Those isolated grizzly tubercle and red tubercle on uniform rough mucosa are of no statistical significance with the pathological change of the non uniform rough mucosa.To those cases characterized by gastric antrum mucosa rough appearance concomitant of grizzly dent with alternatively red-and-white color but majorly red appeared,the comparable difference is of no statistical significance between the grizzly dent and non uniform roughness and its grizzly dent.[Conclusion] The uniformity of gastric antrum mucosa roughness could be introduced as the estimation basis to the rough mucosa atrophic and its non atrophic chronic gastritis;regardless of the extent of grizzly dent concomitant,its gastroscope certification should only be oriented to the white area;the mucosa rough extent classification under gastroscope verification is of clinical significance.