Giá trị của thang điểm Kyoto trong chẩn đoán nhiễm Helicobacter pylori ở bệnh nhân viêm dạ dày mạn tính trên 60 tuổi

Abstract

Objective: To evaluate the value of the Kyoto score in the diagnosis of Helicobacter pylori infection in patients over 60 years old with chronic gastritis. Subject and method: A cross-sectional descriptive study on 130 patients over 60 years old with chronic gastritis at 108 Military Central Hospital. Endoscopic findings were assessed according to the Kyoto classification score: Atrophy, intestinal metaplasia, enlarged fold, nodularity, diffuse redness. H. pylori infection was determined by a combination of urease test and histopathology, H. pylori infected if both methods were positive. Result: Of the 130 subjects enrolled, 62/130 (4.7%) had H. pylori infection. The prevalence of mild; moderate; severe atrophy were 36.9%, 60.8%, 2.3%. The prevalence of intestinal metaplasia, enlarged fold, nodularity, diffuse redness were 5.4%, 14.6%, 4.6%, 22.3%. The Kyoto score was distributed from 0 to 4. The Kyoto score had an excellent AUROC (0.907, 95% confidence interval: 0-86-0.955, p=0.000) for predicting H. pylori infection with a cut-off value of 2. The sensitivity, specificity, positive predictive value, negative predictive value and the accuracy were 69.4%, 95.6%, 93.4%, 77.3% and 83.1%. Of the 5 endoscopic features, diffuse redness was the most valuable in diagnosing H. pylori with the highest AUROC (0.688; 95% CI: 0.594-0.781, p=0.048), specificity was 95.6%, the positive predictive value was 89.7%. Conclusion: The Kyoto classification score had a high accuracy in predicting H. pylori infection in patients over 60 years old with chronic gastritis.