14C-尿素呼气试验检测幽门螺杆菌感染的临床应用

目的探讨14C-尿素呼气试验(14C-UBT)检测幽门螺杆菌(Hp)感染的临床应用价值。方法选取128例患者因上消化道症状接受胃镜检查患者,以快速尿素酶试验(RUT)和血清HP抗体胶体金试验联合检测作为诊断HP感染的"金标准",评价14C-UBT诊断Hp感染的敏感性、特异性和准确性。结果金标准阳性70例中,14C-UBT检测阳性为67例,阴性为3例;金标准阴性58例中,14C-UBT检测阴性为56例,阳性为2例。14C-UBT检测诊断Hp感染的敏感度95.7%(67/70),特异度96.6%(56/58),准确性96.1%(123/128),阳性预测值97.1%(67/69),阴性预测值94.9%(56/59)。14C-UBT、RUT、血清Hp抗体胶体金试验等3种方法的敏感性、特异性、准确性经非参数检验法检验,差异均无统计学意义。结论14C-UBT有较高的敏感性和特异性,是一种简便可靠,非侵入性的诊断Hp感染的方法,易于临床推广。

Clinical application of 14C-urea breath test in diagnosing Helicobacter pylori infection

Objective To investigate the clinical application value of 14 C - urea breath test （ 14 C - UBT） in the detection of Helicobacter pylori （ H. pylori） infection. Methods Rapid urease test （RUT） and serum H. pylori antibody gold colloid test were performed in 128 patients who had gastroscopy for gastrointestinal symptoms. H. pylori status was evaluated by three different tests： rapid urease test, serology test and 14C - urea breath test. The combined detection of rapid urease test and serum H. pylori antibody gold colloid test was regarded as ＂gold standard＂ to evaluate the sensitivity, specificity and accuracy of 14 C - urea breath test in diagnosing H. pylori infection. Results Seventy patients were diag- nosed as H. pylori positive and 58 as negative by ＂gold standard＂. 14C -urea breath test was positive in 67 of 70 patients and negative in 56 of 58 patients. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 14C -urea breath test were 95.7% （67/70）, 96.6% （56/58）, 96.1% （123/128）, 97.1% （67/69） and 94.9% （56/59） respectively. Conclusion The data suggest that 14 C - UBT is a simple, reliable, non - invasive method and has high sensitivity and specificity for the detection of HP infection.