幽门螺杆菌表型与胃粘膜炎性细胞浸润的关系

目的 探讨幽门螺杆菌(Helicobacter pylori,Hp)各表型与慢性胃炎的严重程度和慢性活动性胃炎的关系.方法 经胃镜及组织学检查确诊为慢性胃炎115例.按中华医学会制定的标准确定Hp感染阳性85例,阴性30例.用免疫印迹法检测Hp细胞毒素相关蛋白(CagA)、空泡毒素(VacA)、尿素酶(Urease)及其亚型.用Updated Sydney System评价Hp相关性慢性胃炎中慢性炎症(CI)、多形核活动性(PA)组织学等级.结果 ①中重度CI组HP感染及128KDCagA、116KDCagA、95KDVacA、91KDVacA、30KDUreA表达比例显著高于轻度CI 组(P<0.05);②无PA组HP感染及95KDVacA、91KDVacA和30KDUreA表达比例明显低于有PA组(P<0.05).结论 ①HP128KDCagA,116KDCagA,95KDVacA,91KDVacA、30KDUreA是引起和加重慢性胃炎的重要因子;②HP95KDVaeA.91KDVaeA、30KDUreA可能是胃粘膜炎症急性活动及炎性细胞侵润的诱导因子.     

半夏泻心汤治疗幽门螺杆菌相关性胃炎的临床观察

目的研究半夏泻心汤对幽门螺杆菌（Hp）相关性慢性胃炎（寒热错杂证）的治疗效果。方法将120例Hp感染的慢性胃炎随机分为治疗组与对照组。治疗组60例，予半夏泻心汤治疗；对照组60例，予金得乐治疗，疗程均为四周。观察临床症状、镜下改变、胃黏膜病理的变化和HP根除情况。判定疗效。同时观察并比较两组病例的副反应发生情况。结果两组病例于治疗后，主要临床症状明显改善（P〈0．05），Hp的根除情况显著（P〈0.05），胃镜下胃粘膜炎症的改变明显（P〈0．05），病理组织学检查显示慢性炎症、活动性炎症均减轻（P〈0.05）。两种治疗方法的胃镜下炎症改变相近似，而在主要的临床症状、HP的根除上、病理组织学改善上治疗组明显优于对照组。治疗组的不良反应发生率为3.33％，对照组为13．33％（P〈0.05）。结论半夏泻心汤治疗幽门螺杆菌相关性慢性胃炎（寒热错杂证），可以有效地提高HP的根除及临床症状的改善，减轻胃粘膜的炎症反应，标本兼治，调节机体整体功能，不良反应少。提示半夏泻心汤在治疗Hp相关性胃炎（寒热错杂证）上疗效肯定，值得临床推广应用。     

幽门螺杆菌感染与慢性荨麻疹发病的关系分析

【目的】探讨幽门螺杆菌（Hp）感染与慢性荨麻疹发病的关系,分析抗Hp治疗对慢性荨麻疹临床疗效影响。【方法】选择2013年1月至2015年6月本院收治的102例慢性荨麻疹患者为研究对象,选取医院同期体检健康者102例作为对照组。观察组经13C呼气试验检测将HP阳性患者随机分为A组（45例）和B组（44例）,13例Hp阴性患者作为C组。A、B、C组均给予依巴斯汀片10毫克／次,1次／日,连续服用3个月,A组联合抗HP四联疗法,观察各组疗效及治疗后复发情况。【结果】慢性荨麻疹患者Hp阳性率87．25％显著高于健康者HP阳性率30．39％（x2=68．0810,P〈0．05）;经治疗后,A、C组患者总有效率分别为91．11％（41／45）、84．62％（12／13）显著高于B组的43．18％（19／44）（x2=23．2653、9．7624,P〈0．05）;治疗后A组13C呼气检测值显著低于B组（P〈0．05）,A组治疗前后Hp感染情况明显好转（P〈0．05）,B组治疗前后HP感染无显著变化;A组总复发率显著低于B组（P〈0．05）,A组总复发率低于C组,但无统计学差畀（P〉0．05）;治疗前A、B组IgE水平均显著高于C组（P〈0．05）。【结论】慢性荨麻疹发病可能与Hp感染相关,Hp阳性患者联合抗Hp四联疗法有利于治疗慢性荨麻疹。     

幽门螺杆菌抗体组分与特发性血小板减少性紫癜发病的相关性分析

目的分析幽门螺杆菌（HP）抗体组分与特发性血小板减少性紫癜（ITP）发病的相关性。方法应用免疫印记法检测73例ITP患者和51例对照者的血清HP抗体组分：细胞毒素相关基因A（CagA）128、CagA116、CagA110、空泡毒素蛋白A（VacA）95、VacA91、尿素酶A（UreA）、尿素酶B（UreB）,同时进行14C尿素呼气试验（14C-UBT）。结果ITP组患者14C-UBT检测阳性率高于对照组,差异有统计学意义（χ^2=3.88,P〈0.05）;两组HP抗体组分CagA110、VacA91水平比较,差异均有统计学意义（χ^2分别=13.51、12.49,P均〈0.05）;而两组CagA128、CagA116、VacA95、UreA、UreB水平比较,差异均无统计学意义（χ^2分别=1.65、3.41、1.59、0.63、3.37,P均〉0.05）。结论HP抗体组分CagA110、VacA91与ITP发病相关。     

幽门螺杆菌感染与脑梗死的相关性研究

目的 研究幽门螺杆菌（Hp）感染与脑梗死（CI）的相关性。方法 选择102例无明显消化道症状的脑梗死患者，72例年龄性别匹配的健康对照者，采用单克隆抗体蛋白芯片方法检测血清中的细胞毒素相关蛋白（CagA）、尿素酶（Ure）和空泡细胞毒素（VacA）3种Hp抗体，比较两组抗体的阳性率及菌株分型的差异，分析脑梗死发生的危险因子。结果 CI组血清中的CagA、Ure、VaeA抗体的阳性率和Hp的感染率分别为：46．1％、88．2％、48．0％、88．2％，对照组相应的阳性率为：18．1％、43．1％、19．4％和43．1％，两组之间差异有非常显著意义（P〈0．01）；其中CI组90例Hp感染者菌株分型比例为：Ⅰ型33．3％、Ⅱ型26．7％、中间型加．0％，2对照组32例Hp感染者菌株分型比例为：Ⅰ型15．6％、Ⅱ型53．1％、中间型31．3％，两组的菌株型差异有显著意义（P〈0．05）。结论 Hp感染是脑梗死发生的危险因子之一，Ⅰ型Hp感染者比Ⅱ型Hp感染者患CI的危险性更大。     

脑梗死患者幽门螺旋杆菌感染状况调查及其致病危险性分析

目的探讨幽门螺杆菌（Helicobacter pylori，HP）感染及其产生的毒力因子与脑梗死（cerebral infarefion，CI）的关系。方法采用ELISA方法检测对245例脑梗死患者和221例健康体检者血清中的抗．HP-IgG，用Westem-blot方法检测血清抗CagA抗体以及抗VacA抗体，比较合并HP感染的脑梗死患者与非HP感染者之间的差异。结果①脑梗死组抗．HP-IgG阳性率明显高于非脑梗死组（59．2％和41．6％，P〈0．05），去除常见的危险因素后，HP感染仍增加患脑梗死的危险性（OR=2．08，95％CI1．46—3．01）。②动脉粥样硬化性血栓性脑梗死组的HP感染率明显高于其余各类脑梗死组和非脑梗死组，P〈0．05；③HP CagA^＋VacA^＋毒力亚型感染增加患动脉粥样硬化性血栓性脑梗死的危险性（OR=2．96,95％CI1．84—4．74），而CagA^＋／VacA^＋毒力亚型和CagA^-VacA^-毒力亚型感染并未明显增加患动脉粥样硬化性血栓性脑梗死的危险性。结论HP感染是脑梗死危险因素，尤其与动脉粥样硬化性血栓性脑梗死相关，CagA^＋VacA^＋毒力亚型感染可能更增加患动脉粥样硬化性血栓性脑梗死的危险性。     

慢性胃炎患儿家族内幽门螺杆菌亚型感染分析

目的了解慢性胃炎患儿家族幽门螺杆菌（Hp）感染的情况以及家族内幽门螺杆菌亚型的分布。方法采集14例因反复腹痛来我院就诊的患儿及其家庭成员共73例的静脉血,应用幽门螺杆菌金标免疫斑点法和免疫印迹法对患儿及其家族成员进行Hp抗体和亚型的检测。结果慢性胃炎患儿家族中Hp抗体阳性率i00％,免疫印迹Hp亚型抗体阳性率95．9％,其中I型Hp感染占60．3％,Ⅱ型Hp感染占35．6％。I型HP及Ⅱ型Hp感染阳性率在患几与二级亲属之间差异均有统计学意义（P〈0．05）,VacA抗体检出率在有胃肠道疾病组（66．7％）及无胃肠道症状组（35．3％）之间差畀有统计学意义（P〈O．05）。家族成员患Hp感染胃肠道疾病有家庭聚集现象。结论慢性胃炎患儿家族中Hp感染阳性率高,I型Hp感染阳性率随年龄的增加而升高,Ⅱ型Hp感染阳性率随年龄的增加而降低,VacA抗体的分布与消化道症状有关。     

幽门螺杆菌感染与慢性胃炎红细胞免疫功能变化的关系

目的：探讨幽门螺杆菌感染与慢性胃炎患者红细胞免疫功能的影响。方法：采用红细胞C35受体花环（RBC-C3b RR）试验、免疫复合物花环（RBC-ICR）试验、免疫粘附促进因子（RFER）百分率及抑制因子（RFIR）百分率试验,检测315例慢性胃炎患者与30例健康体检者红细胞免疫功能情况。结果：慢性胃炎组RBC-C3bRR、RFER明显低于对照组（P＜0.01,R＜0.05),RBC-ICR、RFIR高于对照组（P＜0.05,P＜0.01);Hp阳性组RBC-C3bRR明显低于Hp阴性组（P＜0.05),RBC-ECR明显高于HP阴性组（P＜0.05),RFER、RFIF两组间比较未见显著差异;对186例Hp阳性根除治疗前、后红细胞免疫功能对比发现治疗后RBC-ICR明显低于根除前,其余指标无显著改变。结论：Hp的感染可能导致宿主红细胞免疫功能紊乱,其感染可能是慢性胃炎患者红细胞免疫功能下降的主要原因。     

幽门螺杆菌感染与慢性胃炎相关性

目的探讨幽门螺杆菌（Hp）感染与慢性胃炎发生及发展相关性。方法对行胃镜检查2 789例慢性胃炎病人的胃镜及病理检查结果进行回顾性分析,研究慢性胃炎与Hp感染关系。结果中老年组（40～87岁）Hp感染发生率明显高于青年组（18～39岁）,差异有显著性（χ2=46.60、29.08,P〈0.01）;不同性别组间Hp感染的发生率差异无显著性（P〉0.05）。活动性胃炎组Hp感染率为99.0%,中重度感染占51.5%,均明显高于非活动性胃炎组（χ2=179.93,P〈0.01）。慢性浅表性胃炎的Hp感染率为83.6%,慢性萎缩性胃炎为95.4%,二者比较差异有显著性（χ2=28.88,P〈0.01）。Hp感染阳性组重度胃炎、肠上皮化生及异型增生的发生率均较Hp阴性组高,差异有显著性（uc=-30.19～-13.17,P〈0.01）。结论慢性胃炎的发生和发展与Hp感染密切相关。     

幽门螺杆菌及其血清抗体测定与胃镜及组织学检查结果的对比分析

目的研究幽门螺杆菌（Hp）感染及其血清抗体的测定与不同胃黏膜病变之间的关系，探讨Hp感染血清学抗体检测的临床意义。方法1509例慢性胃炎病人进行Hp和组织学检测，用ELISA测定不同组病人的血清抗Hp IgG抗体。结果①合并淋巴集结组的Hp检出率为68．33％，显著高于淋巴集结阴性组的20．71％（P〈0．01）。②在Hp感染病人中胃镜检查胃黏膜病变弥漫全胃组血清抗Hp抗体测定滴度OD值显著高于病变局限于胃窦组（0.906：0.533，P〈0.05）。③Hp感染者胃黏膜合并淋巴集结组血清抗Hp抗体滴度OD值显著高于组织学检测淋巴集结阴性组（0.922：0.516，P〈0.05）。结论①Hp感染与胃黏膜组织中出现淋巴集结关系密切。②血清学抗Hp抗体IgG的测定OD值较高者往往提示胃黏膜病变范围较广，组织学病变程度较重。应该筛选出来做胃镜检查或密切随访，用ELISA方法测定血清特异性的IgG抗体的具体滴度值，在临床工作中对于初筛病人、分析病情及确定下一步诊疗方法有一定的实用意义。     

Association between Helicobacter pylori cytotoxic type I CagA-positive strains and migraine with aura

Recent studies have suggested an association between Helicobacter pylori infection and migraine. However, various strains of the bacterium are present, some endowed with greater pathogenicity. In particular, H. pylori type I CagA-positive strains induce a higher release of proinflammatory substances by the gastric mucosa that could trigger systemic vasospasms. The aim of the present study was to assess the prevalence of H. pylori CagA-positive strains in subjects with migraine. One hundred and seventy-five patients affected by migraine (49 with aura, 126 without aura) were consecutively enrolled and matched for sex, age, social background and geographical origin with 152 controls. Helicobacter pylori infection was assessed through 13C-urea breath test. Specific serological IgG against CagA were detected through ELISA. The prevalence of H. pylori infection was similar in migraine patients and in controls (40% vs. 39%, respectively). Among migraine patients, prevalence of infection was not related to presence or absence of aura (45% vs. 37%, respectively). However, among infected subjects, a significantly higher prevalence of CagA-positive strains was observed in patients affected by migraine with aura when compared with those affected by migraine without aura (41% vs. 19%, P < 0.01) and with controls (41% vs. 17%, P < 0.01). CagA-positive H. pylori strains were found to be strongly associated with migraine with aura. A higher inflammatory response of the gastric mucosa to more virulent strains could release substances that may act as triggers of vasospasm in peculiar cerebral arterial districts, probably implicated in the 'aura' phenomenon.     

Barrett食管患者幽门螺杆菌感染率的Meta分析

目的分析Barrett食管患者幽门螺杆菌感染率及caga阳性的幽门螺杆菌感染率，并与内镜检查正常者和胃食管反流病患者比较，探讨幽门螺杆菌（Helicobacter pylori，Hp）感染与Barrett食管的关系。方法计算机检索MEDLINE和EMbase数据库至2008年2月，纳入比较Barrett食管患者和内镜检查正常者及胃食管反流病（gastroesophageal reflux disease，GERD）患者Hp感染率的病例对照研究或队列研究。统计分析采用RevMan4．2．8，计算比值比OR（95％CI）。结果共纳入19篇文献，包括16篇病例对照研究和3篇队列研究。病例对照研究分析结果显示，Barrett食管患者比内镜检查正常者Hp感染率低[OR0．56，95％CI（0．40，0．79）]，与GERD患者相比差异无统计学意义[OR0．86，95％CI（0．74，1．00）]。队列研究的分析结果显示，Barrett食管患者与内镜检查正常者及GERD患者相比Hp感染率差异无统计学意义[OR1．12，95％CI（0．77，1．61）；OR1．10，95％CI（0．32，3．83）]。cagA阳性Hp感染率较内镜正常者及GERD患者低[OR0．30，95％CI（0．12，0．74）；OR0．55，95％CI（0．33，0．94）]。病例对照研究长节段较短节段Barrett食管Hp感染率低[OR0．32，95％CI（0．16，0．66）]。而队列研究结果显示，长节段较短节段Barrett食管患者Hp感染率差异无统计学意义[OR0．66，95％CI（0．29，1．48）]。结论Barrett食管患者和GERD患者Hp感染率无差别，Barrett食管患者Hp感染率，特别是cagA阳性Hp菌株感染率较内镜检查正常者明显减少。     

幽门螺杆菌阳性患者健康知识认知的调查分析

目的 了解门诊体检患者对幽门螺杆菌感染相关知识的认知状况,分析造成认知差异的影响因素,为门诊开展幽门螺杆菌感染健康教育活动的方式方法提供依据。方法 采用自设问卷于2013年8月至2014年2月在门诊开展幽门螺杆菌感染相关知识调查。结果 调查对象为336例检测结果阳性患者, 16~、30~、50岁患者检出率分别为23.51%、34.82%、41.67%,差异有统计学意义(P0.01);对幽门螺杆菌主要传播途径(唾液传播、饮食不洁、不良卫生习惯)的正确认识率约为47.22%,初中以下文化程度者选择率达31.43%,高中及以上文化程度者选择率为68.57%。结论 门诊体检不同文化层次、不同职业患者对幽门螺杆菌感染的重视程度、相关知识了解情况存在偏差,应进行针对性的健康教育,以减少健康人群的幽门螺杆菌感染率。     

Helicobacter pylori seroprevalence in patients with mild asthma

Helicobacter pylori (H. pylori) is causally related to chronic active gastritis, peptic ulcer disease, primary low-grade B-cell gastric lymphoma, and is also a risk factor for gastric cancer. In addition, a high seroprevalence of H. pylori has been found in many extragastrointestinal disorders, including active bronchiectasis and chronic obstructive pulmonary disease (COPD). It appears that H. pylori has a close relationship with respiratory diseases, but data in the literature on the relationship between H. pylori infection and asthma are poor. We therefore investigated the relationship between them. In this study we evaluated 46 patients with mild asthma, 48 age- and sex-matched patients with peptic ulcer and 48 healthy control subjects. All enrolled subjects underwent a serologic test for H. pylori IgG and cytotoxin-associated gene-A (CagA) by enzyme-linked immunosorbent assay (ELISA). There was no significant difference in both anti-H. pylori IgG seropositivity (p=0.6580) and anti-H. pylori-CagA IgG seropositivity (p=0.7183) between the asthmatic and control subjects. In contrast, both anti-H. pylori IgG seropositivity and anti-H. pylori-CagA IgG seropositivity were significantly higher in peptic ulcer patients than these in asthmatic patients (p<0.01). Despite the sero-epidemiological association of H. pylori infection with many inflammatory conditions, our data show no significant association between mild asthma and H. pylori infection.     

Association of CagA-positive infection with Helicobacter pylori antibodies of IgA class

cagA gene, the best known virulence factor of Helicobacter pylori, codes for an immunodominant CagA protein. In this study, CagA antibodies of the IgG class were measured by immunoblot or enzyme immunoassay in subjects with positive H. pylori serology, and the presence of CagA antibodies was compared with that of H. pylori antibodies of IgA and IgG classes. Serum samples were available for a total of 1,481 subjects, including gastroscopied patients with biopsy-verified H. pylori infection, smoking men with a normal or low serum pepsinogen I level indicating atrophic corpus gastritis, and subjects who later developed gastric cancer and their matched controls. CagA antibodies were significantly more prevalent among individuals with elevated H. pylori antibody titres of the IgA class than in those with IgG antibodies only, with the exception of a small subgroup of individuals who later developed gastric cancer. CagA-positive H. pylori strains seem to induce an immune response with a markedly higher frequency of IgA than what is found in inflammation caused by CagA-negative strains. The presence of serum IgA antibodies to H. pylori seems to indicate a higher risk for CagA-positive H. pylori infection and possibly more severe late sequelae of the disease.     

Normal serum pepsinogen I levels in adults: a population-based study with special reference to Helicobacter pylori infection and parietal cell antibodies

OBJECTIVE: Low serum pepsinogen I (PG I) values are common in subjects with advanced corpus atrophy with or without parietal cell antibodies (PCA). Elevated values are usual during Helicobacter pylori infection. MATERIAL AND METHODS: PG I levels were determined in two randomly selected cross-sectional adult population samples using the Gastroset PGI test kits. The sera (408 in 1973 and 504 in 1994), tested earlier for H. pylori infection and now for PCA, represented subjects living in Vammala, Finland. RESULTS: In the PCA-negative population, the mean (+/-SD) PG I level was significantly higher in men than in women among both H. pylori-negative (88.13+/-34.16 microg/l versus 72.43+/-29.31 microg/l; p<0.0001) and H. pylori-positive (110.50+/-50.59 microg/l, versus 97.74+/-44.82 microg/l, p<0.0001) subjects; the difference between all H. pylori-positive and -negative subjects was also significant (p<0.001). In the 10-year age groups, age had no impact on the mean PG I levels in H. pylori-negative subjects (p=0.860). In the PCA-positive population, the 10 H. pylori-positive subjects had higher mean PG I levels (112.96+/-53.62 microg/l) than the 13 H. pylori-negative subjects (32.57+/-27.59 microg/l; p=0.002); the latter mean was also significantly lower than that of the PCA- and H. pylori-negative subjects (80.08+/-32.69 microg/l; p<0.0001). CONCLUSIONS: Men had higher normal PG I values than women, but there was no significant variation by age. H. pylori infection was associated with elevated PG I levels and a small decrease with increasing age. Non-infected PCA-positive subjects showed the lowest mean PG I level.     

胆汁反流性胃炎、反流性食管炎与幽朗螺杆菌的关系探讨

目的：探讨幽门螺杆菌(Hp)与胆汁反流性胃炎(BRG)、反流性食管炎(RE)的关系。方法：对192例病人作胃镜检查，并对胃或食管粘膜分别作快速尿素酶试验和病理学妇科白带涂片快速染色法(CTB)，进行分级。结果：BRG患者的Hp感染率为88．88％(96／108)，RE患者的Hp感染率为35．71％(30／84)，BRG组Hp感染率明显高于RE组，差别有显著意义；BRG患者CTB分级较RE高，差别有显著意义。Hp阳性RE患者胃镜分级、病理程度与Hp阴性组比较，差别无显著意义。结论：胆汁反流性胃炎与幽门螺杆菌感染有密切关系，而反流性食管炎与幽门螺杆菌的关系不确定。     

消化性溃疡的复发与幽门螺杆菌感染168例分析

目的:观察消化性溃疡的复发与幽门螺杆菌(HP)感染的关系。方法:回顾性分析我院168例消化性溃疡病人的临床资料,从胃镜检查、碳14(一种检测HP的呼气试验)测试、病理组织活检及治疗后随访3年结果进行分析。结果:HP阳性率为82.8％,其中胃溃疡最高,为88.9％,其次为十二指肠球部溃疡、复合性溃疡、幽门前区溃疡,检出率分别为85.3％、60％、57.1％,经统计学处理P<0.01,提示HP感染与溃疡部位有相关性。随访发现溃疡病伴有HP感染的复发率较高,达30％,而单纯的消化性溃疡、无HP感染的3年复发率为5％左右。结论:HP感染是消化性溃疡复发的重要因素。     

Prevalence of Helicobacter pylori infection in asymptomatic subjects in Libya

Helicobacter pylori infection is very common infection worldwide particularly in the developing countries. No detailed study on such infection is being recorded so far in Libya. The aims of the study were to detect H. pylori prevalence in asymptomatic Libyan subjects, to determine the rate of infection among different age groups and to correlate the prevalence of H. pylori with age, sex, smoking, non-steroidal anti-inflammatory drugs intake, marital status, education, and socioeconomic status. Three hundred and sixty asymptomatic subjects 1->70 years of age (average 36) with no previous history of epigastric pain were selected randomly from the Libyan population. Serum samples were obtained and a questionnaire was filled for each subject. The ELISA test was used to detect IgG anti-H. pylori antibodies. An overall prevalence of 76% was detected in these subjects. A 50% infection rate were in subjects 1-9 years of age that increased to 84% in subjects 10-19 years and continued with increasing age and reached up to 94% in those over 70 years of age. Subjects > 45 years of age had significantly higher antibody response than those <45 years. H. pylori prevalence was higher in married subjects (84%) as compared to singles (68%) and similarly in illiterates (89%) and low socioeconomic subjects (91%). No difference in sex, smoking and NSAIDs intake was recorded. Infection with H. pylori is highly prevalent in the Libyan asymptomatic subjects. Infection acquired early in childhood and reached up to 94% in older age. Prevalence of H. pylori was significantly increased in association with marital status, education and low socioeconomic status.     

Quantitative correlation of Helicobacter pylori stool antigen (HpSA) test with the severity of H. pylori-related gastritis

The Helicobacter pylori (H. pylori) load in both stomach and stool and the resulting severity of gastritis are important criteria in validating the status of H. pylori infection. We aimed to assess the reliability of the H. pylori stool antigen (HpSA) test for the primary diagnosis of H. pylori infection by calculating the best cut-off value to obtain the highest sensitivity and specificity in dyspeptic patients. We also investigated the correlation of HpSA test with the severity of gastritis and H. pylori load. The H. pylori statuses of 95 patients were evaluated by the positivity of both rapid urease test and microscopic detection of H. pylori in biopsy specimens, 88 subjects of whom were H. pylori positive. The sensitivity and specificity of the HpSA test were 51.1% (45/88) and 100% (7/7), respectively, according to the manufacturer's recommended cut-off value of 0.16. However, with the best cut-off value of 0.048, calculated by receiver operator characteristics analysis, the sensitivity of the test increased to 92.0% (81/88) with the same specificity. High values of the HpSA test were correlated with high scores of corpus H. pylori load and the severity of antrum and corpus inflammation (p < 0.05). With the best cut-off value of the HpSA test, the primary diagnosis of H. pylori infection can be made with higher sensitivity and specificity. The HpSA test is a helpful tool that evaluates the severity of H. pylori infection and the degree of gastric inflammatory activity and gastric H. pylori load.