Application of ultrafine gastroscopy combined with Kyoto gastritis classification in Helicobacter pylori infection and analysis of drug sensitivity results
Objective To analyze the morphological changes of gastric mucosa under white light endoscope,and to evaluate the diagnostic and practical value of the white light endoscopy in the diagnosis of H.pylori-associated gastritis in our country.Methods A total of 232 patients who underwent both ultrafine gastroscopy,14 C urea breath test(UBT),histopathology test and H.pylori antibody test were included in the study.The Kyoto gastritis score was calculated by the diagnostic criteria of Kyoto classification,the diagnostic accuracy and efficacy of endoscopic gastric mucosal manifesta-tions in the diagnosis of H.pylori were analyzed,and the drug sensitivity test was performed.Results The accuracy,sensitivity and specificity of Kyoto gastritis score≥2 in predicting H.pylori infection were 90.09%,94.54%and 73.47%,respectively.The plicae widening and swelling had higher sensitivity and lower specificity.The sensitivity and specificity of diffuse redness,white mucous and spot redness were higher.The sensitivity and specificity of atrophy and mucosal edema were lower.The proportion of atrophy,plicae widening and swelling,tubercles,diffuse redness,white turbidous mucous,punctate redness and mucosal edema in H.pylori infection patients were significantly higher than those in H.pylori non-infection patients(P<0.05).The risk factors of H.pylori infection were atrophy,plicae widening and swelling,tubercles,diffuse redness,white turbidous mucous,punctate redness and mucosal edema(P<0.05).Among the 110 H.pylori positive specimens,the drug resistance rates of Amoxicillin,Clamycin,Metronidazole,Levo-floxacin,Tetracycline and Furazolidone were 9.09%,66.36%,81.82%,60.91%,0.91%and 0,respectively.Met-ronidazole resistance was significantly higher in patients with gastroscopic atrophy,plicae widening and swelling,tuber-cles,diffuse redness,white turbidous mucous and spot-like redness than in patients without the above gastroscopic mani-festations(P<0.05).Conclusion Ultrafine gastroscopy combined with Kyoto classification of gastritis can increase the detection rate of H.pylori,and the eradication rate of H.pylori can be increased by giving priority to Amoxicillin,Fura-zolidone and Tetracycline with low resistance rate,ultrafine gastroscopy combined with Kyoto classification of gastritis can effectively and timely detect H.pylori resistance.
Ultrafine gastroscopyKyoto classification of gastritisHelicobacter pyloriCultivation and drug sensi-tivity testing
NETL
NSTL
万方数据
维普
