【摘要 】 目的 改革国外对幽门螺杆菌(Helicobacter pylori，Hp)感染可视化诊断中的繁杂方法。方法 对300例经胃镜检查病例，在胃镜直视下采用喷洒pH 5.5的调节水来调整胃黏膜表面的pH值，再对胃黏膜表面直接喷洒0.5 mol/L尿素-0.1% 酚红溶液。通过酚红的变红反应，使Hp的感染及其分布可视化。并对尿素-酚红液变色呈阳性反应的病例，在变色部位取活检，对呈阴性反应的不变色病例，在胃窦近幽门2cm左右的前、后壁、胃窦前庭或胃体大弯分别取活检2～3块，进行病理组织切片的Giemsa染色检查并将两者相对照。结果 300例中190例胃镜喷洒尿素-酚红溶液后胃黏膜表面变红呈阳性反应，病理检查Hp呈阳性者182例，诊断符合率为95.8%(182/190)。110例呈阴性反应病例，病理检查Hp呈阴性者95例，两者符合率为86.4%(95/110)。镜下诊断与病理诊断总符合率为92.3%(277/300)。结论 对Hp感染的可视化诊断，改良的尿素-酚红液喷洒为一种简单可行的内镜下诊断方法。
The clinical research of visible diagnosis of Helicobacter pylori infection Liu Bin, Gong Baoli,Bi Chunshan,et al.Tongren Hospital, Beijing 100730
【 Abstract 】 Objective We improved the complicated method of visible diagnosis of Helicobacter pylori (Hp) infection. Methods With 300 patients being administrated with gastroscopic examination, we sprayed modulating water, with pH was 5.5, to adjust pH of gastric mucosa, then sprayed 0.5 mol/L solution of urea-0.1% phenol red directly to the surface of gastric mucosa. The infection and distribution of Hp could be found through the reaction, which the solution of phenol red appeared red. We biopsied 2-3 pieces from anterior, posterior wall, and antrum in the region of gastric sinus about 2 cm near the pylorus, or greater curvature in all positive cases, contrasting with pathological slices stained with Giemsa. Results 190 cases were positive, contrasting with 180 cases being positive in pathological examination of Hp. The coincident rate was 95.8%(182/190). 110 cases were negative, contrasting with 95 cases being negative in pathological examination of Hp. The coincidence between gastroscopic and pathological examination was 92.3%(277/300). Conclusion It showed that the improved solution of urea-phenol red was a simple and available method in diagnosis of Hp infection under endoscope.
【 Key words 】 Helicobacter pylori Urease Diagnosis
幽门螺杆菌(Hp)在胃黏膜的感染 ......
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