高分辨率显微内镜对溃疡性结肠炎黏膜愈合的评估价值

被引：5

作者：

王寅璞 ^{[1
]}

屈亚威 ^{[2
]}

贾馥华 ^{[2
]}

刘晓不殆 ^{[2
]}

刘海峰 ^{[2
]}

机构：

[1] 锦州医科大学武警总医院研究生培养基地, 北京

[2] 武警总医院消化内科, 北京

来源：

中华消化内镜杂志 | 2019年 / 36卷 / 04期

关键词：

结肠炎, 溃疡性; 黏膜愈合; 评估; 高分辨率显微内镜;

D O I：

暂无

中图分类号：

R574.62 [结肠疾病];

学科分类号：

100201 [内科学];

摘要：

目的探讨高分辨率显微内镜(HRME)评估临床缓解期溃疡性结肠炎(UC)患者黏膜愈合的诊断价值。方法随机选择30例UC患者, 采集HRME图像, 以病理结果作为金标准制定HRME评估结肠黏膜状态的诊断标准。再对67例患者进行前瞻性研究, 先行标准内镜评估结肠黏膜状态并获取活检标本, 再对标本采集HRME图像。利用统计学方法比较标准内镜与HRME评估溃疡性结肠黏膜愈合的准确性。结果根据腺体形态、腺体排列方式、腺体开口及炎细胞浸润等指标制定HRME评估UC黏膜状态的标准, 分为0～3级共4个级别。67例患者113个位点的前瞻性研究结果显示:标准内镜评估UC患者黏膜愈合的敏感度、特异度、阳性预测值、阴性预测值分别为44.68%(21/47)、90.91%(60/66)、77.78%(21/27)、69.77%(60/86), 与病理结果比较, 一致性检验的Kappa值为0.379(P<0.05);HRME成像评估UC患者黏膜愈合的敏感度、特异度、阳性预测值、阴性预测值分别为87.23%(41/47)、95.45%(63/66)、93.18%(41/44)、91.30%(63/69), 与病理结果比较, 一致性检验的Kappa值为0.835(P<0.05)。结论 HRME可对UC患者结肠黏膜实现实时虚拟病理组织成像, 评估黏膜愈合的准确性优于标准内镜。

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