^14C—尿素呼吸试验在幽门螺杆菌根除治疗前后的检测价值

目的：观察短程瓣三联抗菌药物在十二指肠溃疡患者中的根除效果及＾１４Ｃ－尿素呼吸试验（＾１４Ｃ－ＵＢＴ）在治疗前后的检测价值。方法：５６例十二指肠溃疡患者，经内镜活检组织快速尿素酶试验，Ｗａｒｔｈｉｎ－Ｓｔａｒｒｙ染色及＾１４Ｃ－ＵＢＴ检查，二项阳性者诊断为ＨＰ感染。阳性患者给予奥美拉唑、克拉霉素及替哨唑治疗１周，疗程一１月及３月分别进行＾１４Ｃ－ＵＢＴ检测ＨＰ。结果：十二指肠溃疡患者ＨＰ感染率为９     

^14C—尿素呼气试验对胃幽门螺杆菌感染的诊断价值

目的：建立＾１４Ｃ－尿素科气试验方法,检测并探讨该方法对胃幽门螺杆菌（ＨＰ）感染的诊断价值。方法：对临床上确诊或疑有ＨＰ感染的慢性胃炎、胃十二指肠溃疡、不明原因上腹痛、便潜血阳性,抗菌治疗后复查检者及无症状自荐受检者等共２８００例,３６６０人次的患者进行＾１４Ｃ－尿素呼气试验。结果：受检者２８００例,首次＾１４Ｃ－尿素呼气试验阳性者１５２６人,阳性率为５４．６％;部分患者经一个疗程的抗ＨＰ治疗,其     

胶囊微量法^14C—尿素呼气试验诊断幽门螺杆菌感染

目的：建立胶囊微量法＾１４Ｃ－尿素呼气试验（＾１４Ｃ－ＵＢＴ）用于诊断幽直菌（ＨＰ）感染。方法：采用１μＣｉ＾１４Ｃ－尿素，胶囊给药，在收集５，１０，２０，２５，３０，４５，６０ｍｉｎ呼气样本的基础上建立了以＾１４ＣＯ２呼出高峰期为２５ｍｉｎ，直接用１６．６７ｍＢｑ／ｍｍｏｌ表示的检测方法，结果与ＨＰ细菌学培养及病理组织学比较。结果：共检测１３７例病人，ＨＰ阳性８３例，阴性５４例。以ＨＨＰ阴性第２     

^14C—尿素呼吸试验与组织学检查诊断幽门螺杆菌感染的对比研究

【目的】评估＾１４Ｃ尿素呼吸试验（＾１４Ｃ－ＵＢＴ）对幽门螺杆菌（ＨＰ）感染的诊断价值,并探讨胃粘膜组织学变化对实验结果的影响。【方法】取９６例因上腹症状行胃镜检查的患者胃窦粘膜活检,分别行改良Ｇｉｅｍｓａ染色和快速尿素酶（ＲＵＴ）试验,＾１４Ｃ－ＵＢＴ检查;将三项检查中两项（或以上）阳性者定为ＨＰ感染,分别对三种方法进行评价,并且观察其在不同胃粘膜病变中ＨＰ检出情况。【结果】＾１４Ｃ－ＵＢＴ的敏     

残胃对^14C—尿素呼气试验影响的研究

目的评估＾１４Ｃ－尿素呼气试验检测残胃幽门螺杆菌感染的准确性。方法 残胃３２例及对照组４０例患者先用金标准定性，再用＾１４Ｃ－ＵＢＴ检测ＨＰ。结果用金标准检测的残胃和对照组的阴性患者，再用＾１４Ｃ－ＵＢＴ检验未出现假阳性，而残胃组的１２例和对照组的２６例阳性患者用＾１４Ｃ－ＵＢＴ检测各出现一例假阴性。     

快速微量^14C—尿素呼吸试验诊断幽门螺杆菌感染

为简化检查程序，降低检查成本和受检查接受的辐射剂量，建立了一种快速微量简便的＾１４Ｃ－尿素呼吸试验。对１５７例未经抗菌治疗的溃疡、胃炎等上消化道疾病患者，以组织学检查和快速尿素酶试验为诊断幽门螺杆菌感染的金标准。     

对CIBA—CORNING644型Na^＋／k^＋／Cl^—离子选择电极分析仪的开发 …

目的：报告了６４４型分析仪测定Ｎａ＾＋、Ｋ＾＋、Ｃｌ＾－的新通道。方法：应用电极输出功率试验,分别检测定标液和血清标本的Ｎａ＾＋、Ｋ＾＋、Ｃｌ＾－深度,通过计算求得ｍｍｏｌ／Ｌ值。结果：定标液和血清标本经重复试验,Ｎａ＾＋、Ｋ＾＋、Ｃｌ＾－的ＣＶ值均在０．８３％以下。结论：本法结果与火焰光计法比较,差异不显著,Ｐ值均〉０．０５。     

血清学与^13C—尿素呼吸试验检测反复腹痛儿童Hp感染比较

目的 探讨血清学及＾１３Ｃ尿素呼吸试验（＾１３Ｃ－ｕｒｅａ ｂｒｅａｔｈ ｔｅｓｔ,＾１３Ｃ－ＵＢＴ）在检测小儿反复腹痛（ｒｅｃｕｒｒｅｎｔ ａｂｄｏｍｉｎａｌ ｐａｉｎ,ＲＡＰ）幽门螺杆菌（Ｈｐ）感染中的应用及ＲＡＰ与Ｈｐ的关系。方法 采用＾１３Ｃ－ＵＢＴ及血清ＥＬＩＳＡ汉检测抗Ｈｐ－ＩｇＧ。结果 ２００例经＾１３Ｃ－ＵＢＴ检测有５８例检出Ｈｐ感染,检出率２９．４％（１５／５１）,２９．５％（３     

幽门螺杆菌感染的诊断方法

自 198 3年Ｗａｒｒｅｎ及Ｍａｒｓｈａｌｌ发现幽门螺杆菌 (ＨＰ)以来 ,有关ＨＰ及ＨＰ与胃肠疾病之间关系的研究日益扩大与深入。关于ＨＰ感染的诊断方法也不断在改进 ,目前诊断ＨＰ感染的方法可分为侵入性和非侵入性两大类。侵入性检测方法需做胃镜检查和胃粘膜活检 ,并可同时确定胃十二指肠疾病的性质 ,其方法包括快速尿素酶试验、组织病理学检查、细菌培养和聚合酶链反应 (ＰＣＲ)检测技术等。而非侵入性检测方法仅提供有无ＨＰ感染 ,其方法主要有13 Ｃ或14 Ｃ 尿素呼气试验 (13 Ｃ ＵＢＴ或14 Ｃ ＵＢＴ)、血清学试验以及国内刚开始应…     

^14C—尿素呼气试验诊断HP感染临床价值探讨

为探讨非侵入性＾１４Ｃ－尿素呼气试验（ＵＢＴ）的临床诊断价值，２该法对６１例各种慢性胃病患者进行胃粘膜幽门螺杆菌（ＨＰ）感染状况检测，并与快速尿素酶试验（ＲＵＴ）、组织切片蓝染色（ＭＢ）进行比较，结果发现＾１４ＣＵＢＴ检测ＨＰＢ是性率为６．２％，显著高于ＲＵＴ（５０．１％）和ＭＢ法（４８．７％），＾１４Ｃ－ＵＢＴ检测ＨＰ诊断敏感性９１．７％、特异性７７％、阳性预测值７２．６％，阴性预测值９３．２％     

~（14）C－尿素呼吸试验诊断幽门螺杆菌感染的应用

对８０例受试者采用我院建立的￣（１４）Ｃ－尿素呼吸试验，检测患者目前胃内有否幽门螺杆菌（ＨＰ）感染。结果如下：敏感度９１．２％，特异度１００％，准确度９３．８％，阳性预测值１００％及阴性预测值８２．１％。提示其可作为一种与组织学及／或细菌培养相仿的检测ＨＰ感染的“金标准”。     

快速微量~(14)C-尿素呼吸试验诊断幽门螺杆菌感染

为简化检查程序，降低检查成本和受检者接受的辐射剂量，建立了一种快速微量简便的１４Ｃ－尿素呼吸试验（１４Ｃ－ＵＢＴ）。对１５７例未经抗菌治疗的溃疡、胃炎等上消化道疾病患者，以组织学检查（Ｇｉｅｍｓａ染色）和快速尿素酶试验为诊断幽门螺杆菌感染的金标准。患者禁食４小时，于口服３７ｋＢｑ１４Ｃ－尿素前和口服之后１０、２０和３０分钟分别采集呼出气体标本，液闪测定。结果显示以等于或大于２００ｃｐｍ为阳性诊断标准，１４Ｃ－ＵＢＴ的敏感性、特异性、阳性预测值、阴性预测值和正确率分别为９４．７９％，９０．１６％，９３．８１％，９１．６０％和９２．９９％。由此可见３７ｋＢｑ１４Ｃ－尿素，１０分钟采集一次呼出气体标本，以等于或大于２００ｃｐｍ为阳性诊断标准，既能降低辐射剂量和成本，又能获得高准确性的诊断，是值得在临床推广应用的简便方法。     

HpSA: Assessment of a new non-invasive diagnostic assay for helicobacter pylori infection in an Irish population

Background  The diagnosis of Helicobacter pylori is an essential element in the management of many common gastrointestinal pathologies. Previously diagnosis was dependent on the availability of endoscopic biopsy samples. The advent of non invasive assays such as the C13Urea breath test and Elisa serology have enabled diagnosis, and treatment to be undertaken in the primary care setting. The isolation of Helicobacter pylori antigen from stool has led to the development of a new non-invasive test. Aim  A prospective study was designed to assess and compare the performance of Premier Platinum HpSA with current gold standard tests. Methods  Consecutive patients undergoing a gastroscopy for investigation of dyspepsia at the Meath and Adelaide hospitals were enrolled. At endoscopy gastric biopsies were taken for histology, microbiology and rapid urease testing. In addition all subjects had C13UBT, serology and stool tests performed. Individuals who were H. pylori positive received standard proton pump inhibitor based triple therapy. Following treatment all tests, apart from serology were repeated. Results  54 patients were enrolled, 46 per cent were H. pylori positive. HpSA had a sensitivity and specificity and positive and negative predicted values of 96 per cent, 75 per cent and 80.6 per cent, 75.8 per cent respectively and compared favourably with all other tests. The sensitivity and specificities of the other tests were, histology 79.2 per cent and 100 per cent, culture 68 per cent and 100 per cent, rapid urease test 75 per cent and 100 per cent, serology 75 per cent and 96 per cent and C13 urea breath test 100 per cent and 96.6 per cent. Conclusion  The detection of H. pylori antigen in stool by means of a HpSA assay is a new and effective non-invasive means of diagnosis which can be performed in a routine laboratory setting. It is simple to perform and has possible advantages over other non-invasive tests, detecting actual antigen indicating current active infection.     

13C-尿素呼气试验对125例慢性胃炎患者幽门螺杆菌检出情况分析

目的了解13C呼气试验检测幽门螺杆菌(Hp)在慢性胃炎患者中的感染情况,研究其相关性.方法经胃镜检查的125例慢性胃炎患者接受13C-尿素呼气试验,并进行分析研究.结果单纯慢性胃炎患者Hp阳性率明显高于慢性胃炎伴返流性食道炎及伴胆汁返流患者(P<0.05). 结论 13C-尿素呼气试验检测Hp是一种较为简单可靠的方法.Hp对返流性食道炎的发生有保护作用.胆汁对Hp可能有杀伤作用.     

Non-invasive testing for Helicobacter pylori

Confirmed and potential benefits of eradicating Helicobacter pylori have led to the development of a range of diagnostic tests. As well as techniques using biopsy tissue obtained during endoscopy, a number of non-invasive tests are now available. These may be appropriate for pre-endoscopy screening of younger dyspeptics, for use in research, particularly epidemiological surveys, to confirm successful eradication after treatment, and possibly in the future for screening in asymptomatic populations. Serology requiring laboratory analysis is likely to be the least expensive option, particularly suitable for testing large numbers, while urea breath tests should yield the most accurate results and are appropriate for confirming successful eradication since only current infection is detected. The performance of near-patient tests can lack consistency, but these may be useful for small numbers and where other non-invasive testing is unavailable. Tests should be used with an awareness of their potential limitations in terms of accuracy.


     

多种方法检测幽门螺杆菌感染的评价

目的:评价多种方法检测幽门螺杆菌(H.pylori)感染的准确性.方法:对82例因上消化道症状接受胃镜检查患者应用酶免疫反应试验原理进行粪抗原(HpSA)试验,同步进行胃粘膜快速尿素酶试验(RUT)和组织学(MB法)检测,其中67例患者进行14C-呼气试验(14C-UBT)检测H.pylori,以快速尿素酶试验和组织学联合检测作为金标准.结果:HpSA检测诊断Hpylori感染的敏感性93.30%,特异性92.50%,阳性预测值90.30%,阴性预测值94.87%,准确性92.90%;14C-UBT检测诊断H.pylori感染的敏感性81.81%,特异性81.08%,阳性预测值72.00%,阴性预测值88.24%,准确性81.36%.结论:HpSA试验、14C-UBT试验是诊断H.pylori感染的简便、准确和非侵入性的检查方法.     

The 14C-urea breath-test for the detection of gastric Campylobacter pylori infection

A breath-test has been developed for the detection of gastric infection with Campylobacter pylori. Urea that is labelled with carbon 14 is administered to a fasting patient and the patient's breath is sampled for radioactivity over the following 30 minutes. If C. pylori is present in the patient's stomach, urease activity causes hydrolysis of the urea and the 14C is absorbed as carbon dioxide. This carbon dioxide enters the patient's bicarbonate pool and eventually is excreted in the breath. The results are expressed as a percentage of the administered dose/mmol carbon dioxide x kg body weight. Sixty-three patients who were undergoing endoscopy were studied. The radioactivity in exhaled breath which was sampled within five minutes of 14C-urea administration was attributed to the presence of urease enzyme in mouth organisms and was discounted. The time-radioactivity curves for breath samples from five to 30 minutes after the administration of 14C-urea gave an excellent separation between subjects with negative results of the examination of gastric-biopsy samples and patients with microbiological and histological evidence of infection with C. pylori. The area under the time-radioactivity curve at between five and 30 minutes after the administration of 14C-urea in 24 patients with negative microbiological results was 6.9 +/- 4.4 area units; in 35 of 39 patients with positive microbiological results, this area was greater than 40 area units. Measured against the results of the microbiological examination of gastric-biopsy samples, the sensitivity of breath-testing was 90% and the specificity was 100%. Measured against the results of histological examination for the presence of C. pylori infection, breath-testing had a sensitivity of 94% and a specificity of 93%. A positive breath-test result also correlated well (P = 0.0001) with the serological antibody test-result. The role of non-invasive tests--enzyme-linked immunosorbent assays and 14C-urea breath-testing--in the management of gastritis and peptic ulcer disease is discussed. We consider that the 14C-urea breath-test has an important role in the noninvasive confirmation of gastric infection with C. pylori and in the follow-up of patients after treatment.     

Diagnosis of Helicobacter pylori infection： A meta-analysis

Objective： To evaluate effects of diagnostic tests for Helicobacter pylori （H. pylori） infection. Methods ： A meta-analysis was conducted in 22 identified studies through Chinese literature searching which were published after 1995 and evaluated diagnostic tests for Helicobacter pylori （H. pylori） infection. Results： Polymerase chain reaction （PCR） had the best performance with diagnostic odds ratio （DOR） of 6.7 （5. 5-7. 8）, followed by ^13C urea breath test and Enzyme-linked immunosorbent assay （ELISA） quantitative serological test, with DOR being 6.4 （5.4-7. 4） and 4.5 （3. 8-5.2）, respectively. Conclusion： Non-invasive tests are the appropriate methods for screening H. pylori infection, whereas invasive tests are the best methods for ascertaining the suspected patients.     

Comparison of invasive and noninvasive methods for the diagnosis and evaluation of eradication of Helicobacter pylori infection in children

BACKGROUND: Acquisition of Helicobacter pylori infection occurs mainly during childhood. To study the events associated with H. pylori colonization in children it is important to have reliable diagnostic methods. Our objective was to validate invasive and noninvasive tests for diagnosis of H. pylori infection in children before and after antimicrobial treatment. METHODS: Before treatment, invasive rapid urease test (RUT) culture and histology, as well as the noninvasive carbon-13 urea breath test (13C-UBT) and serology were validated in 59 children. The gold standard for H. pylori infection was any of three positives of the five tests. After antimicrobial treatment culture, histology, and 13C-UBT were validated in 43 children to determine eradication. The gold standard for eradication was negative in all three tests. RESULTS: For primary diagnosis, RUT was the most sensitive and specific test, followed by 13C-UBT, which performed better than serology, culture, and histology. Concordance tests also showed that RUT and 13C-UBT performed better. For determination of eradication, 13C-UBT and histology were better than culture, which showed poor sensitivity. CONCLUSIONS: RUT performed better for primary diagnosis. However, as endoscopy might not be indicated in most children, 13C-UBT could be the test of choice for diagnosis of H. pylori infection both before and after eradication treatment.     

幽门螺杆菌感染的检测方法

幽门螺杆菌(HP)感染的检测方法包括侵入性及非侵入性检测方法。侵入性法主要有HP培养、胃黏膜直接涂片革兰染色镜检、胃黏膜组织切片染色镜检、快速尿素酶试验、分子生物学方法等;而非侵入性法主要包括13C或14C尿素呼气试验、15N尿氨排泄试验、粪便HP抗原检测、HP抗体检测等;生物芯片检测技术在HP耐药基因的检测、HP抗原检测及蛋白纯化等方面也取得了一定的进展。