Kawamura分类法在评价幽门螺杆菌感染和胃炎中的价值

目的探讨Kawamura分类法在诊断幽门螺杆菌(H.pylori)感染和评价胃黏膜炎症及萎缩程度中的价值。方法在放大内镜下观察71例H.pylori感染患者的胃体上段大弯侧和小弯侧胃黏膜的腺管开口(COs)。根据腺管开口特点分为“白边黑点(white-edged dark spot)”型、“白色(white)”型、“纯白色(dense white pit,DWP)”型,分别取病理活检。对患者行H.pylori根除治疗,6个月后对根除成功的65例患者复查胃镜,比较根除治疗前后3种分型的分布及不同分型胃黏膜炎症活动度和萎缩程度的差异。结果 H.pylori根除后3种分型的分布与根除前比较差异有统计学意义(P<0.001)。根除治疗前以“white”型为主,根除治疗后以“white-edged dark spot”型为主。“white-edged dark spot”型、“white”型、“DWP”型胃黏膜的炎症程度依次升高,每两组间炎症活动度分布比较差异均有统计学意义(P<0.001)。不同Kawamura分型胃黏膜萎缩程度分布比较差异无统计学意义(P>0.05)。结论 Kawamura分类法有助于评价H.pylori感染及胃黏膜炎症活动度,但在评价胃黏膜萎缩程度方面无显著优势。

Value of Kawamura classification in evaluating Helicobacter pylori infection and gastritis

Objective To explore the value of Kawamura classification in evaluating H.pylori infection,gastric mucosal inflammation and atrophy.Methods The gastric pit crypt openings(COs) in the greater and lesser curvatures of the upper gastric corpus of 71 patients with H.pylori infection were observed under the magnifying endoscopy and divided into “white-edged dark spot” type,“white” type and “dense white pit(DWP)” type according to the COs.Then the pathological biopsy was taken.The patients were received H.pylori eradicaton therapy.After 6 months,65 cases of successfully eradicated patients were performed the gastroscope.The distribution of three types in pre-treatment and post-treatment were compared.The distribution of three types in different degrees of gastric mucosal inflammation activity and atrophy were compared.Results The distribution of the three types in post-treatment was significantly different with that in pre-treatment(P<0.001).The “white” type was dominated in pre-treatment and the “white-edged dark spot” type was dominated in post-treatment.The degree of inflammation was sequentially increased by “white-edged dark spot” type,“white” type,and “DWP” type,and there were significant differences in the distribution between every two groups(P<0.001).There were no significant differences in the distribution of Kawamura types between different degrees of atrophy(P>0.05).ConclusionThe Kawamura classification is useful to determine H.pylori infection and evaluate thegastric mucosal inflammatory activity,but there is no significant advantage in the evaluation of atrophy.