| Aims:1.Evaluate the effects of different drug preparations on gastric cleanliness(GC),so as to determine a better gastric preparation method for magnetically controlled capsule gastroscopy(MCCG).2.Investigate characteristic manifestations of gastric mucosa infected with Helicobacter pylori(HP)by MCCG.Explore the key points for diagnosing HP infection status and evaluate its diagnostic value.Methods:1.The study is divided into two parts.The first part included 100 patients who underwent MCCG examination at Shanghai Jiao-Tong University School of Medicine,Renji Hospital from January 2018 to April 2018.All the subjects were randomly divided into two groups.Group A took simethicone 40 minutes before the examination,while group B took simethicone + pronase;The second part included 100 patients who underwent MCCG examination at Shanghai Jiao-Tong University School of Medicine,Renji Hospital from May 2018 to September 2018.They were randomly divided into two groups.Group C took simethicone + pronase40 minutes before MCCG,while group D took simethicone + pronase1.5 hours before MCCG.Gastric cleanliness was scored excellent,good,fair and poor.Those with good or excellent GC were considered to be qualified2.This study included 56 HP-positive patients and 58 HP-negative patients who underwent MCCG examination at Shanghai Jiao-Tong University School of Medicine,Renji Hospital from October 2018 to January 2019.According to the Kyoto classification of endoscopic gastritis,the endoscopic mucosal features were evaluated.The characteristic manifestations of HP infected mucosa under MCCG were obtained by single factor analysis.The diagnostic criteria of HP infection under MCCG were analyzed by multivariate analysis and its clinical application value was evaluated.Results1.Part I: Qualified rate of GC in group B was higher than that in group A(86% vs.64%,P=0.011),and the examination time of group B was shorter than group A(P=0.043).There was no significant difference in diagnostic yield between the two groups.Part II: Qualified rate of GC in group D was higher than that in group C(96% vs.84%,P=0.046).There was no significant difference in examination time and diagnostic yield between the two groups.2.There were 4 differences in gastric mucosal manifestations between the two groups: mucosal swelling,depressive erosion,spotty redness and regular arrangement of collecting venules(RAC).Among them,spotty redness and RAC can be used as the basis for predicting HP infection status.The accuracy is 86%,the sensitivity is 91.1%,the specificity is 91.4%,the positive predictive value is 91.1% and the negative predictive value is91.4%.The area under the ROC curve is 0.898.Conclusions1.The use of simethicone and pronase 1.5 hours before MCCG examination can improve gastric cleanliness.It is an ideal preparation method for gastric cleaning.2.MCCG can observe the characteristic manifestations of HP infected gastric mucosa: spotty redness,mucosal swelling and depressive erosion.It can also observe the characteristic manifestations of HP uninfected gastric mucosa: RAC in lower part of the body and lesser curvature of the angulus.It is highly effective and reliable to diagnose HP infection status according to RAC and spotty redness. |
