^14C-呼气试验检测幽门螺杆菌感染

本应用国产^14C-呼气试验(^14C-UBT试剂检测幽门螺杆菌(Hp)．同时应用病理组织染色、屎素酶试验、细菌培养和血清ELISA技术等方法与之进行比较。117例病人中Hp阳性率为47.9％(56/117)，^14C-UBT的敏感性与特异性分别为94.6％和93.4％。^14C-UBT由于相对于胃镜依赖的方法而言创伤性大大降低．是目前检测Hp感染，尤其是药物治疗后复查时的首选方法．     

~(13)C-尿素呼气试验诊断幽门螺杆菌感染的研究

本研究旨在评估~(13)C,尿素呼气试验检测幽门螺杆菌感染的可靠性。方法:我们在82例因胃病而行胃镜检查的患者胃窦和胃体取多个活检标本,作组织学、牯膜涂片和快速尿素酶试验,以决定是否感染幽门螺杆菌,并作~(13)C-尿素呼气试验。~(13)C-尿素呼气试验的敏感性、特异性、阳性预测值、阴性预测值是与组织学和尿素酶方法检测幽门螺杆菌的结果比较而计算得到。结果:~(13)C-尿素呼气试验的敏感性97.92％,特异性100％,阳性预测值100％,阴性预测值97.14％,准确性98.78％。结论:~(13)C-尿素呼气试验有高度敏感性和特异性,对确定患者的幽门螺杆菌感染状态是一可靠的无创伤的诊断方法。     

~(13)C-尿素呼气试验诊断幽门螺杆菌感染的临床意义

对 6 5例胃、十二指肠疾病患者和 36例健康人行 1 3 C-尿素呼气试验 (C- UBT)、病理组织学和快速尿素酶(RUT)三种方法检测幽门螺杆菌 (HP) ,其中任两项阳性者认为有 HP感染。结果显示 ,C- U BT、病理组织学和 RUT检测的阳性率分别为 81.5 4%、83.1%、84.6 2 % ;敏感性分别为 96 .2 3%、86 .8%、84.91% ;特异性分别为 10 0 %、91.6 7%、83.33%。认为 C- UBT和病理组织学是检测 HP感染较准确的方法 ,RU T的敏感性与特异性较前两种方法低 ,其操作方便 ,费用低 ,仍是临床常用的检测手段 ,但不能单独作为诊断 HP感染指标。病理组织学和 RU T均为侵入性检查 ,取材也受“灶性”分布的影响 ,而 C- UBT是非侵入性操作 ,更能反映“全胃”HP感染状况 ,临床应用时无任何禁忌和限制 ,如果仅为了检测 HP状态或抗 HP药物疗效监测 ,C- UBT可替代病理组织学及 RUT检查。     

残胃对~(14)C-尿素呼气试验影响的研究

目的:评估用 ~(14)C-尿素呼气试验(~(14)C-UBT)检测残胃幽门螺杆菌(HP)感染的准确性。方法:残胃32例及对照组40例病人先用金标准(胃镜检查时于胃窦和胃体各取两块粘膜活组织,作快速尿素酶试验和常规病理切片5张,Giemsa 染色镜检 HP)定性,再用(~14)C-UBT 检测 HP。用 X~2检验两组结果的准确性。结果:用金标准检测的残胃和对照组的阴性病人(分别为20例和14例)再用~(14)C-UBT 检测未出现假阳性,而残胃组的12例和对照组的26例阳性病人用~(14)C-UBT 检测各出现一例假阴性。两种方法检测的准确性无显著性差别,X~2=0.315,P>0.5。结论:残胃对用~(14)C-UBT 检测 HP 的准确性无影响。     

~(14)C-UBT与尿素酶试验检测幽门螺杆菌感染52例对照观察

幽门螺杆菌（＊P）感染与慢性活动性胃炎、胃十二指肠溃疡病的发生有密切关系，临床上若要对这类疾病作出精确的诊治，需要迅速有效地诊断出有否HP感染。目前诊断HP感染的方法如病理切片染色法、PCR法、细菌培养法以及常用的尿素酶试验等，均属侵人性的检查手段。而’‘C一尿素呼气试验（“C－UBT）诊断有否HP感染不需要做胃镜取材。为了验证’‘C－UBT在临床上应用的可靠性与实用性，我们对52例胃十二指肠疾病患者同期做’‘C－UBT与尿素酶试验，现将结果报告如下。回资料与方法1．l病例选择：52例胃十二指肠疾病患者来自本院消…     

微剂量~(14)C-尿素呼气试验诊断幽门螺杆菌感染

本研究旨在评价微剂量(37kBq)~(14)C-尿素呼气试验(~(14)C-UBT)对幽门螺杆菌(HP)感染的诊断效果。106例病人清晨空腹饮下37kBq~(14)C-尿素水溶液,海胺溶液吸收20分钟呼气CO_2mmol,液闪仪测定~(14)C放射性活性,结果以dpm/mmolCO_2表达。19例志愿者第二日重复试验。以Warthin-Starry组织染色和快速尿素酶试验作为参照标准,ROC分析法确定~(14)C-UBT最适判别值。结果得出~(14)C-UBT最适判别值为250dpm/mmol CO_2;实验对HP感染诊断的敏感性、特异性和准确性分别为98.3％(58/59)、98.7％(46/47)、和98.7％(104/106);实验重复性良好;体重校正对诊断效果无影响。研究结果提示微剂量~(14)C-UBT诊断HP感染具有高度的准确性,且简单和安全;试验无需试餐和加用非标记尿素,结果不需以体重校正。     

14C-呼气试验诊断幽门螺杆菌的临床价值

为探讨一种准确检测幽门螺杆菌(Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,ＨＰ)感染,为病人易于接受的方法,本文就14Ｃ呼气试验(14ＣＵＢＴ)与快速尿素酶试验(ＲＵＴ)作对比,并用14ＣＵＢＴ作抗ＨＰ治疗后的复查,探讨其临床价值。1　对象与方法11　病例选择　118例均经胃镜检查及病理证实为消化性溃疡(ＰＵ)或慢性胃炎(ＣＧ),同时合并ＨＰ感染者。其中ＰＵ57例,ＣＧ61例;男70例,女48例,年龄21～65岁,平均42.1岁。12　ＨＰ阳性或ＨＰ阴性诊断标准　组织学检查发现典型ＨＰ及抗ＨＰ抗体( )为阳性。组织学检查未发现典型ＨＰ及抗ＨＰ抗体(-)为阴…     

^13C—尿素呼气试验诊断幽门螺杆菌感染的研究

目的评估13C-尿素呼气试验（13C-UBT）幽门螺杆菌（Hp）感染的可靠性。方法对82例因胃病而行胃镜检查的患者，于胃窦和胃体取多个活检标本作组织学、粘膜涂片和快速尿素酶试验，以决定是否感染Hp，并作13C-UBT。结果13C-UBT的敏感性、特异性、阳性预测值、阴性预测值是与组织学和尿素酶方法检测Hp的检测结果比较而计算得到。13C-尿素呼气试验的敏感性97．92％、特异性100％、阳性预测值100％、阴性预测值97．14％、准确性98．78％。结论13C-尿素呼气试验有高度敏感性和特异性，对确定患者的Hp感染状态是一非常可靠而又无创伤的诊断方法。     

~(14)C-尿素呼气化验检测150例幽门螺杆菌感染结果分析

目的研究14C-尿素呼气试验对幽门螺杆菌（Helicobacterpylori,Hp）检测的敏感性、特异性及临床实用性．方法慢性胃炎40例、胃溃疡30例。十二指肠球溃疡50例、胃癌20例、胃息肉8例、门脉高压性胃病2例，上述病例均经纤维内镜检查、活检病理证实．其中有15例十二指肠溃疡、5例胃溃疡，用PPI四联除菌治疗1mo后进行对比，14C-尿素采用r-闪烁仪记数计算结果．结果①慢性胃炎，十二指肠球溃疡、胃溃疡、胃癌各组14C-UBT检测Hp感染率无统计学差异；②慢性胃炎与十二指肠球溃疡14C-UBT放射性活度值无差异；③慢性胃炎伴糜烂、萎缩、肠化生的HP感染放射性活度值差异显著，明显高于无上述病变组，t检验P＜0．05；④20例治疗前胃、十二指肠球溃疡患者经1moPPI除菌治疗后14C-UBT检测阳转阴率为100％结论14G-UBT是一种灵敏性高、特异性强的检测HP的有效方法．     

14C-尿素呼气试验对幽门螺杆菌感染的诊断价值

目的：评估^14C-尿素呼气试验（^14C-UBT）对幽门螺杆菌（HP）感染的诊断价值。方法：对2000例1月内未曾使用可能影响HP检测结果的药物者同步完成快速尿酶试验（RUT）、病理、^14C-UBT检测，以病理（HE染色）、RUT均阳性为诊断HP感染的标准，评价^14C-UBT对HP感染的诊断价值。结果：^14C-UBT的敏感性89.7％，特异性98.4％，阳性预测值98.4％，准确性93.4％，阴性预测值88.1％。结论：^14C-UBT是HP感染无创伤、敏感而特异的诊断方法。     

Dual therapy for third-line Helicobacter pylori eradication and urea breath test prediction

We evaluated the efficacy and tolerability of a dual therapy with rabeprazole and amoxicillin (AMX) as an empiric third-line rescue therapy. In patients with failure of first-line treatment with a proton pump inhibitor (PPI)-AMX-clarithromycin regimen and second-line treatment with the PPI-AMX-metronidazole regimen, a third-line eradication regimen with rabeprazole (10 mg q.i.d.) and AMX (500 mg q.i.d.) was prescribed for 2 wk. Eradication was confirmed by the results of the 13C-urea breath test (UBT) at 12 wk after the therapy. A total of 46 patients were included; however, two were lost to follow-up. The eradication rates as determined by per-protocol and intention-to-treat analyses were 65.9% and 63.0%, respectively. The pretreatment UBT results in the subjects showing eradication failure; those patients showing successful eradication comprised 32.9 ± 28.8 permil and 14.8 ± 12.8 permil, respectively. The pretreatment UBT results in the subjects with eradication failure were significantly higher than those in the patients with successful eradication (P = 0.019). A low pretreatment UBT result (≤ 28.5 permil) predicted the success of the eradication therapy with a positive predictive value of 81.3% and a sensitivity of 89.7%. Adverse effects were reported in 18.2% of the patients, mainly diarrhea and stomatitis. Dual therapy with rabeprazole and AMX appears to serve as a potential empirical third-line strategy for patients with low values on pretreatment UBT.     

Gender-associated differences in urea breath test for Helicobacter pylori infection referrals and results among dyspeptic patients

AIM: To verify whether there is a gender difference in the 13C-urea breath test results in a large cohort. METHODS: The test results of dyspeptic patients referred for 13C-urea breath testing between January and December, 2007 were evaluated. Testing was carried out at the health insurance organization branches and evaluated at a central laboratory in Israel. RESULTS: Of a total of 28 746 test results, 18 122 (63.04%) were from females and 10 624 (36.95%) from males. Overall, 10 188 (35.4%) results [expressed as delta over baseline (DOB)] were positive (DOB 13C > 5), 18,326 (63.7%) were negative (DOB 13C < 3.5) and 232 (0.8%) were borderline (DOB 13C 3.5-5). There was a significant difference between the total positive rate among females and males (34.8% vs 37.2%, respectively, P = 0.0003). The mean test value was increased by approximately 10 units for females compared to males (P < 0.01) and this difference was consistent for all age groups (i.e., between 10-80 years of age, P < 0.01). CONCLUSION: More females were referred to 13C-urea breath testing. More males had positive results. The mean test values were significantly higher among females of all age groups, possibly representing an increased bacterial load among females and suggesting gender-associated differences in Helicobacter pylori host interactions.     

超微剂量14C-尿素呼气试验诊断幽门螺杆菌感染

目的探索１８５ｋＢｑ１４Ｃ尿素呼气试验（ＵＢＴ）诊断幽门螺杆菌（Ｈｐ）的可行性及ＵＢＴ计数与Ｈｐ定量及炎症的关系．方法共１６１例，ＵＢＴ在内镜检查前进行，继１８５ｋＢｑ１４Ｃ尿素溶液吸服２０ｍｉｎ后采集呼出气标本；再吸饮３７ｋＢｑ１４Ｃ尿素溶液，１５ｍｉｎ后再收集标本；测定１４ＣＯ２活性．内镜下取胃窦、胃角及胃体粘膜活检，分别作尿素酶试验、培养、组织Ｇｉｅｍｓａ染色诊断Ｈｐ及病理学检查（ＨＥ染色）判定炎症，任一部位任两项阳性者判为Ｈｐ阳性，３个部位均阳性为（＋＋＋），２个部位阳性为（＋＋），仅１个部位阳性为（＋），炎症分级参照此标准．结果胃粘膜活检Ｈｐ阳性者８３例（５１６％），ＵＢＴ诊断Ｈｐ的敏感性和特异性分别９４０％和９７４％；Ｈｐ（＋＋＋）与Ｈｐ（＋）组间有显著差异（Ｐ＜００５），但炎症程度与活动性与ｍｉｎ－１无明显相关（Ｐ＞００５）．结论１４ＣＵＢＴ是诊断Ｈｐ高度敏感和特异的方法，其计数和Ｈｐ定量之间有良好的相关性，而与胃粘膜炎症无关．     

13C-尿素呼气试验对幽门螺杆菌密度及胃黏膜炎症的判断价值

目的 探讨６１３Ｃ尿素呼气试验（ＵＢＴ）对幽门螺杆菌（Ｈｐ）感染密度及胃黏膜炎症程度的判断价值。方法 以病理组织学为对照,分析ＵＢＴ对Ｈｐ诊断的准确性并比较不同细菌感染密度以及不同炎症细胞浸润程度时ＵＢＴ结果（ＤＯＢ值）的差异。结果 ＵＢＴ对Ｈｐ诊断的敏感性为９３．２％,特异性为８９．１％。Ｈｐ感染密度重度组的ＤＯＢ值显著高于轻中度组（Ｐ〈０．０５）,ＷＳ染色分级与ＤＯＢ值之间具有弱相关性（ｒｓ＝     

幽门螺杆菌检测方法研究新进展

本文就近年来幽门螺杆菌检测方法新进展作一简要的概述,主要从细菌培养、快速尿素酶实验、组织学检查、尿素呼气实验、抗体检测、粪便抗原检测和分子生物学检测等几个方面展开。     

14C-urea breath test in patients undergoing anti-tuberculosis therapy

AIM: Urea breath test (UBT) is a non-invasive diagnostic test for detecting the presence of Helicobacterpylori(H pylori). In this study we evaluated the effect of anti-tuberculosis therapy on the results of 14C-UBT. METHODS: Patients, with the diagnosis of tuberculosis (TB) who had a positive UBT at the point of starting anti-TB therapy, were included. None had a history of peptic ulcer disease or had taken antibiotics, bismuth compounds and/or PPI in the previous month. 14C-UBT was repeated at the end of the second month and the end of treatment period and one month after completion of treatment course. RESULTS: Thirty-five patients (23 males) were enrolled. 14C-UBT was negative in all 35 patients (100%) at the end of the second month and remained negative in 30 cases (85.7%) at the end of the treatment course. One month after completion of treatment course, UBT remained negative in 13 patients (37.1%). CONCLUSION: Our report underscores the need for caution while interpreting urea breath test results in patients undergoing anti-TB therapy. Furthermore, the combination of drugs used in this study resulted in H pylori eradication in a minority of patients.     

[14C]urea breath test for diagnosis ofHelicobacter pylori

H. pylori is a potent urease producer, a characteristic that has been exploited in the development of the[¹⁴C]- and [¹³C]urea breath tests. The prevalence of H. pylori infection also is known to increase with advancing age; however, the individual patient's age has not routinely been considered when interpreting urea breath test results. The aim of this study was to validate a short, age-adjusted [¹⁴C] urea breath test for use in diagnosing H. pylori infections. Forty-one subjects (28 volunteers, 13 patients) underwent esophagogastroduodenoscopy with biopsies. Subjects were defined as being H. pylori positive if histology or culture was positive. In addition, all subjects completed a 120-min [¹⁴C]urea breath test. A logistic regression analysis adjusting for age was used to estimate the probability of H. pylori positivity as a function of the¹⁴C values generated. Sixteen subjects were H. pylori-positive, and 25 were H. pylori negative. The¹⁴C values generated between 15 and 80 min were found to be equally predictive in identifying H. pylori-positive subjects. Advancing age was associated with a higher probability of H. pylori positivity. By taking advantage of the statistical probabilities, older patients could be accurately diagnosed with H. pylori at lower¹⁴C values. We found that [¹⁴C]urea breath test to be both a sensitive and specific test that can be abbreviated to a 30-min examination (total test time). Moreover, our mathematical model indicates that a patient's age should be considered in order to optimize interpretation of the [¹⁴C]urea breath test, although further observations are needed to confirm this model.Supported in part by grant DK34988 from the National Institutes of Health, U.S. Public Health Service.This work was presented in part at the American College of Gastroenterology Annual Meeting, New Orleans, October 1989, and published as an abstract in theAmerican Journal of Gastroenterology (84:1166, 1989).     

A combination of the Helicobacter pylori stool antigen test and urea breath test is useful for clinical evaluation of eradication therapy: a multicenter study

BACKGROUND: Helicobacter pylori stool antigen (HpSA) test is a new tool for evaluating the H. pylori infection. The present study was carried out to investigate the clinical usefulness of the HpSA test in the evaluation of eradication therapy by comparing it with the (13)C-urea breath test (UBT). METHODS: One hundred and five patients received eradication therapy for H. pylori. After more than 8 weeks, the success of the therapy was evaluated by the HpSA test and the UBT. Concordant results were regarded as a final diagnosis, but when the results were discordant, histological examination was carried out. RESULTS: Of the 105 patients receiving eradication therapy for H. pylori, 25 patients were regarded as H. pylori positive by the UBT and and 20 patients were regarded as H. pylori positive by the the HpSA test. Nine patients (8.6%) showed discordant results (seven cases with UBT(+) and HpSA(-), and two with UBT(-) and HpSA(+)). Five cases out of nine were ultimately judged as having a false-positive result of the UBT, and in these cases the UBT values were relatively low (below 10 per thousand). The final diagnostic accuracies of the UBT and the HpSA test were 94.3% (88.0-97.9%; 95% CI) and 97.1% (91.9-99.4%), respectively. When we used the HpSA test in cases with weakly positive UBT values, we were able to diagnose the correct status of H. pylori infection after eradication in 99% of all patients (94.8-100.0%). CONCLUSION: The HpSA test is a useful tool for the evaluation of eradication therapy and a combination of the HpSA test and UBT is clinically recommended.     

Comparison of a monoclonal antigen stool test （Hp STAR） with the ^13C-urea breath test in monitoring Helicobacter pylori eradication therapy

AIM: To evaluate the agreement between a mAb-based stool test (HP StAR) and the urea breath test (UBT) in monitoring (H pylori) infection after eradication therapy. METHODS: Patients with discordant results on UBT and Hp StAR underwent endoscopy with biopsies for rapid urease test, culture, and histology to confirm H pylori status. RESULTS: Among 250 patients (50±14 years), 240 (96.0%) had concordant UBT and Hp StAR tests with a significant correlation between DOB and 4 values (R=0.87; P<0.0001). The remaining 10 (4.0%) patients had discordant tests (positive Hp StAR and negative UBT) with the Hp StAR inaccurate in five cases (false positive) and UBT inaccurate in the other five cases (false negative). The "maximal expected" sensitivity, specificity, +PV, -PV, +LR, and -LR were 91%, 100%, 100%, 97.4%,∞, and 8.2 respectively, for the UBT, and 100%, 97.4%, 91%, 100%, 38.8, and 0, respectively, for the Hp StAR. Overall accuracy for both tests was 98%. CONCLUSION: Both the UBT and the Hp StAR are equally accurate in monitoring H pylori infection. Nowadays, the choice of the "best" non-invasive H pylori test in the post-treatment setting should be done not only in terms of diagnostic accuracy but also in view of cost and local facilities.