基于荧光 ROSE 的幽门螺杆菌实时可视化技术在HP除菌治疗全程动态评估中的应用研究
Application of Fluorescence ROSE-Based Real-Time Visualized Technology for Helicobacter pylori in the Dynamic Evaluation of the Entire Course of Eradication Therapy
张林 1侯艳红 1李炳慧 1吴凯 1张静 1杨汨1
作者信息
摘要
背景：荧光快速现场评价（ROSE）可实时可视化幽门螺杆菌（HP）并区分活菌（黄绿色）与死菌（橘红色），但其在除菌治疗全过程中的细菌活性及形态演变规律尚不明确。目的： 动态观察HP阳性患者除菌治疗不同阶段的细菌活性、球化形态变化，同步对比内镜及尿素呼气试验（UBT）结果，明确荧光ROSE在疗效评估与复发预警中的价值。方法： 纳入224例HP阳性接受标准铋剂四联疗法（14天）的患者，分为治疗前（A组，n=62）、治疗中（B组，n=55）、治疗后早期（C组，n=58）、治疗后晚期（D组，n=49）。所有患者行胃镜%2B荧光ROSE检测，记录活菌/死菌比例、球化率、内镜分型及UBT OD值。结果： 活菌比例从A组（57.3±11.2%）降至C组（5.8±3.9%）；D组中根除成功亚组（n=36）活菌近于零，复发/耐药亚组（n=13）回升至38.2±10.5%（P＜0.001）。球化率在B组显著升高（65.3±12.1%），复发亚组球化菌中活菌占17.9±6.1%。治疗中及治疗后早期，活菌比例下降显著早于UBT OD值回落（r=0.79，P＜0.001），且部分患者内镜改善滞后。治疗中活菌比例＞30%预测除菌失败的AUC=0.887（95%CI：0.834–0.940）。结论： 荧光ROSE能实时、动态追踪HP除菌全程的细菌活性变化，较UBT更早反映疗效，识别耐药/复发风险，为除菌治疗即时监测与个体化调整提供重要工具。
Abstract
Background: Fluorescence rapid on-site evaluation (ROSE) enables real-time visualization of Helicobacter pylori (HP) and distinguishes between viable (yellow-green) and non-viable (orange-red) bacteria. However, the patterns of bacterial viability and morphological changes throughout the entire course of eradication therapy remain unclear. Objective: To dynamically observe bacterial viability and coccoid morphological changes in HP-positive patients at different stages of eradication therapy, synchronously compare them with endoscopic and urea breath test (UBT) results, and clarify the value of fluorescence ROSE in therapeutic efficacy assessment and recurrence warning. Methods: A total of 224 HP-positive patients receiving standard bismuth-based quadruple therapy (14 days) were enrolled and divided into four groups: pre-treatment (Group A, n=62), during treatment (Group B, n=55), early post-treatment (Group C, n=58), and late post-treatment (Group D, n=49). All patients underwent gastroscopy plus fluorescence ROSE examination. The proportion of viable/dead bacteria, coccoid formation rate, endoscopic classification, and UBT optical density (OD) value were recorded. Results: The proportion of viable bacteria decreased from Group A (57.3±11.2%) to Group C (5.8±3.9%). In Group D, the successful eradication subgroup (n=36) showed nearly zero viable bacteria, whereas the recurrence/drug resistance subgroup (n=13) showed a rebound to 38.2±10.5% (P<0.001). The coccoid formation rate significantly increased in Group B (65.3±12.1%), and in the recurrence subgroup, viable bacteria accounted for 17.9±6.1% of coccoid forms. During treatment and early post-treatment, the decline in viable bacterial proportion significantly preceded the decrease in UBT OD values (r=0.79, P<0.001), and some patients showed delayed endoscopic improvement. A viable bacterial proportion >30% during treatment predicted eradication failure with an AUC of 0.887 (95%CI: 0.834–0.940). Conclusion: Fluorescence ROSE enables real-time, dynamic tracking of changes in bacterial viability throughout the entire course of HP eradication, reflects therapeutic efficacy earlier than UBT, identifies risks of drug resistance and recurrence, and provides an important tool for real-time monitoring and individualized adjustment of eradication therapy.关键词
荧光 ROSE/幽门螺杆菌/除菌治疗/动态监测/细菌活性/球化/尿素呼气试验Key words
Fluorescence ROSE/Helicobacter pylori/Eradication therapy/Dynamic monitoring/Bacterial viability/Coccoid formation/Urea breath test引用本文复制引用
张林,侯艳红,李炳慧,吴凯,张静,杨汨.基于荧光 ROSE 的幽门螺杆菌实时可视化技术在HP除菌治疗全程动态评估中的应用研究[EB/OL].(2026-06-02)[2026-06-10].https://www.biomedrxiv.org.cn/article/doi/10.12201/bmr.202606.00007.学科分类
临床医学/内科学
