ĐẶC ĐIỂM SỰ SẮP XẾP CÁC TĨNH MẠCH GÓP TRÊN NỘI SOI VÀ TÌNH TRẠNG NHIỄM HELICOBACTER PYLORI Ở BỆNH NHÂN VIÊM LOÉT DẠ DÀY TÁ TRÀNG

Abstract

Objective: To describe the arrangement of collecting venules on endoscopy and the status of Helicobacter pylori infection in patients with peptic ulcer disease. Subjects and Methods: A cross-sectional descriptive study was conducted on 144 patients with gastric diseases examined at Thai Nguyen National Hospital from August 2024 to August 2025. Results: Male patients accounted for 57.6%, with the 50–59 age group being the most common (26.4%). The majority were of Kinh ethnicity (92.4%), and abdominal pain was the most frequent presenting symptom (93.1%). Endoscopic findings revealed positive RAC (Regular Arrangement of Collecting Venules) in 48.6% and positive IRAC (Irregular RAC) in 27.1%. Edema and hyperemia were the most frequent findings (95.1%), while atrophy and hypertrophy were less common (4.2% and 2.1%, respectively). The rate of positive CLO test was 29.2%. Negative RAC and positive IRAC were significantly associated with H. pylori infection (p < 0.001). RAC showed an excellent diagnostic performance with AUROC = 0.994 (p = 0.000), sensitivity 94.1%, and specificity 94.7%, especially in patients aged ≥ 60 years. Cohen’s Kappa index indicated moderate agreement (0.3–0.6), with RAC demonstrating higher reproducibility than IRAC (0.37 vs. 0.21). Conclusion: Endoscopic signs of RAC and IRAC are reliable indicators for predicting Helicobacter pylori infection in patients with peptic ulcer disease. Negative RAC and positive IRAC were strongly associated with infection (p < 0.001), while RAC exhibited superior sensitivity, specificity, and interobserver agreement. These endoscopic features can serve as simple, low-cost, and useful adjunctive tools for predicting H. pylori infection in clinical practice.