5种幽门螺杆菌检测方法的比较

目的通过对不同幽门螺杆菌检测方法的比较为临床检测提供参考。方法于2012年1月～2015年1月采集537例消化道疾病患者的胃黏膜组织、血液、粪便等标本，综合应用胃黏膜组织染色法、快速尿素酶试验法、13C-尿素呼气试验、血清抗体检测法和粪便抗原HpSA法进行幽门螺杆菌检测，观察各方法的敏感度、特异度、准确度以及与诊断标准的吻合度。结果537例受检者中共检出幽门螺杆菌感染327例，占60.9%；男性患者感染率为61.4%、女性患者感染率为60.5%，两者比较差异无统计学意义(χ2=1.437，P=0.067)。5种检测方法中，组织染色检测的灵敏度最高，为0.979；血清抗体检测的灵敏度最低，为0.896，总体差异有统计学意义(χ2=7.465，P=0.027)。13C尿素呼气试验检测的特异度最高，为0.900；血清抗体检测特异度最低，为0.810，总体差异有统计学意义(χ2=13.733，P=0.000)。13C尿素呼气试验的准确度最高，达0.946，各方法总体差异有统计学意义(χ2=8.753，P=0.007)，5种方法的吻合度κ值为0.789～0.913，13C尿素呼气试验最高，血清抗体最低。结论5种方式均能有效检测幽门螺杆菌，13C尿素呼气试验诊断价值较高，适合在临床推广。

Comparison of 5 Kinds of Detection Methods for Helicobacter Pylori

ObjectiveTo provide reference for clinical test by compare 5 kinds of detection methods of helicobacter pylori (Hp)．MethodsFrom Jan 2012 to Jan 2015，a total of 537 cases patients with digestive disease were detected with HE histology，urease testing，13C-breath test-instructions，ELISA technique and antigen assay (HpSA)．The specificity，sensitivity，degree of accuracy and goodness of fit were compared．ResultsThere were 327 cases with Hp infection，the infection rate was 60.9%．The infection rate of male was 61.4% while female was 60.5%．There　was no statistical significance(χ2=1.437，P=0.067)．The HE section staining had the highest sensitivity (0.979) while the ELISA technique had the lowest sensitivity (0.896)．There was statistical significance(χ2=7.465，P=0.027)．The 13C-UBT had the highest specificity (0.900) while the ELISA technique had the lowest (0.810)．There was statistical significance(χ2=13.733，P=0.000)．13C-UBT had the highest goodness of fit (0.946)(χ2=8.753，P=0.007)．13C-UBT had the highest goodness of fit while the ELISA technique had the lowest，the Kappa value was from 0.789～0.913．ConclusionAll the methods are effective to Hp detection．13C-UBT has higher diagnostic value among them and worth to clinical extension．