胃镜检查胃黏膜形态判断幽门螺杆菌感染的准确性

Accuracy of morphology of gastric mucosa by gastroscopy in the judgment of Helicobacter pylori infection

目的探讨胃镜检查胃黏膜形态判断幽门螺杆菌(Hp)感染的准确性。方法回顾性分析170例胃镜检查患者的临床资料,将胃镜检查期间通过目测胃黏膜形态判断胃黏膜Hp感染的医生分为高年资、中年资、低年资医生,分别负责80、50、40例患者的胃镜检查。以13 C呼气试验为金标准,评估胃镜检查胃黏膜形态判断Hp感染的准确性、特异性与敏感性,同时分析高年资、中年资、低年资医生在胃镜检查时目测胃黏膜形态判断Hp感染的准确性、特异性、敏感性差异。结果本组患者经胃镜检查胃黏膜形态判断提示Hp感染的准确度为82.94%(141/170),特异度为72.50%(29/40),敏感度为86.15%(112/130);高年资医生判断Hp感染的准确性、敏感性高于中年资医生,准确性、特异性、敏感性高于低年资医生,差异有统计学意义(P<0.05)。结论胃镜检查胃黏膜形态判断Hp感染的准确性较高,并在一定程度上受诊断医师经验的影响。

Objective To investigate the accuracy of morphology of gastric mucosa by gastroscopy in the judgment of Helicobacter pylori(Hp)infection.Methods Clinical materials of 170 patients with gastroscopy were retrospective analyzed.The doctors who judged Hp infection of gastric mucosa by visual examination during gastroscopy were divided into senior qualification doctors,middle qualification doctors and junior qualification doctors,who were respectively responsible for gastroscopy of 80,50 and 40 patients.Taking the results of 13 C Exhale Test as the gold standard,the accuracy,specificity and sensitivity of gastroscopy in the examination of morphology of gastric mucosa for judgment of Hp infection were evaluated.The differences of accuracy,specificity and sensitivity of gastroscopy in the examination of morphology of gastric mucosa for judgment of Hp infection among senior qualification doctors,middle qualification doctors and junior qualification doctors were analyzed.Results The accuracy of morphology of gastric mucosa by gastroscopy in the judgment of Hp infection was 82.94%(141/170),the specificity was 72.50%(29/40),and the sensitivity was 86.15%(112/130).The accuracy and sensitivity of Hp infection judged by senior qualification doctors were significantly higher than those by middle qualification doctors,and the accuracy,specificity and sensitivity of Hp infection judged by senior qualification doctors were significantly higher than those by junior qualification doctors(P<0.05).Conclusion The accuracy of gastroscopy in the examination of morphology of gastric mucosa for judgment of Hp infection is high,and to a certain degree,it is affected by the experience of diagnostic physicians.