采用不同方法检测幽门螺杆菌的感染情况

目的 探讨几种不同方法检测幽门螺杆菌感染的临床效果,分析幽门螺杆菌感染与性别、年龄及疾病的相关性.方法 选取2012年8月至2014年8月在我院消化科门诊就诊的806例患者,分别采用尿素呼气试验法,免疫胶体金法以及病理组织切片染色镜检进行检测,以尿素呼气试验法作为金标准,比较免疫胶体金法与病理组织切片染色镜检法检测Hp的阳性预期值、阴性预期值、敏感度、特异性并比较不同性别、不同年龄及不同疾病Hp的感染率.结果 Hp检出率为37.5％,其中男性感染率为37.3％,女性为37.7％,差异无统计学意义(P＞0.05);随着年龄增长Hp感染率有升高趋势,差异有统计学意义(P＜0.05);确诊为慢性胃炎、消化性溃疡、胃息肉、胃癌的Hp感染率分别为48.6％、50.2％、21.6％、13.8％,慢性胃病的发生与幽门螺杆菌感染有一定的关联.免疫胶体金法以及病理组织切片染色镜检的敏感度分别为83.77％、93.05％,特异性分别为75.20％、83.53％,阳性预期值分别为66.93％、77.20％,阴性预期值为分别为88.55％、95.25％.结论 胶体金法适用于大批量的流行病学调查,病理组织切片染色镜检敏感性高,可作为Hp感染筛查的方法之一.Hp感染率与年龄、疾病种类相关,与性别无关,为幽门螺杆菌感染的流行病学资料提供依据.     

幽门螺杆菌尿素酶B单克隆抗体的制备、鉴定及应用

目的：制备幽门螺杆菌（Hp）尿素酶B（ureB）单克隆抗体并鉴定。 方法： 以Hp重组纯化蛋白ureB为抗原，运用杂交瘤技术制备ureB单克隆抗体，用间接ELISA法检测抗体免疫学活性，用双抗夹心的IRMA法检测不同单抗是否识别相同的表位，并用于检测Hp感染。 结果： 获得两株识别不同表位的ureB单抗杂交瘤细胞，可测得Hp 感染的相关抗原。 结论： 抗ureB单抗可特异性与Hp结合，可用于建立幽门螺杆菌现症感染的检测方法。     

评价大便抗原试验诊断和随访儿童期幽门螺杆菌感染

研究的目的就是评价实施一种新的已发展的酶免疫技术 (Hp SA)检测儿童大便中的幽门螺杆菌抗原。这个研究的比较了 5 8例已经用于各种内窥镜评价的胃肠症状和胃与十二指肠镜和 11例治疗后随访的患者 ,在第一组 ,2 3例儿童用细菌学和组织学方法被诊断为幽门螺杆菌阳性 ,2 0例用大便抗原检测是阳性 ,敏感性是 86 .9%,并且阴性预告值是91.9%,因为 ,用 Hp SA检测仅观察到一个假阳性反应 ,特异性是 97.1%,并且阳性预告值是 95 .2 %,治疗后的结果通过随访获得。8例治疗后感染被根除的儿童 ,Hp SA分析结果是阴性 ,并且有 2 /3持续感染的患者可得…     

两种方法检测十堰市健康体检人群幽门螺杆菌的感染情况

目的 调查十堰市健康体检人群幽门螺杆菌(Hp)感染情况,比较尿素呼气试验(UBT)和粪便Hp抗原试验(HpSAT)在Hp检测中的一致性.方法 于2016年1月至-2017年12月对在十堰市太和医院体检的1883人采用13C尿素呼气试验进行Hp感染检测,分析Hp感染率,并随机抽取600人采用UBT和Hp SAT两种方法共同检测,比较其检出结果的相关性.结果 共检出Hp感染者832例,感染率为44.2％.不同年龄、性别、吸烟史和消化道疾病家族史Hp感染率差异有统计学意义;年龄越高感染率越高,男性高于女性,吸烟者高于不吸烟者,有消化道疾病家族史者高于无消化道疾病家族史者(P＜0.05).UBT和Hp SAT的Hp检出结果有相关性.以UBT为金标准,Hp SAT的灵敏度为92.0％,特异性为88.2％.结论 十堰市健康体检人群Hp感染率与全国水平相当,有必要在人群中普及Hp防治知识,积极筛查和采取治疗措施,降低消化道疾病的发生率.UBT和Hp SAT均可作为Hp检测的重要手段.     

特异性抗原幽门螺杆菌尿素酶B的体外表达

目的：建立自患者体内分离的幽门螺杆菌菌株及其抗原尿素酶B(ureB)体外表达的方法。方法：分离培养胃病患者感染的幽门螺杆菌，采用基因体外重组技术分离ureB基因，并经测序鉴定，所表达的抗原蛋白用Western blot进行鉴定。结果：测序结果证实克隆的基因与GeneBank中的序列相符，经Weslern blot证实获得ureB的重组蛋白。结论：获得了高表达的重组抗原蛋白，为ureB检测及Hp感染的诊断提供了物质基础。     

2型糖尿病患者幽门螺杆菌感染根除率的临床研究

目的：观察2型糖尿病合并幽门螺杆菌（Hp）感染患者的HP感染根除率.方法：120例Hp阳性患者,根据病史分为糖尿病组和非糖尿病组,均经口服埃索美拉唑、阿莫西林加克拉霉素治疗10 d.治疗前、停药6周后均行快速尿素酶试验,检测Hp,并对比两组Hp根除率.结果：糖尿病组的Hp根除率为60.3%,非糖尿病组为85.5%,两者间差异有统计学意义（P＜0.01）.结论：2型糖尿病患者Hp感染根除率低.     

13C-尿素呼气试验检测胃幽门螺杆菌感染2275例报告

目的 了解全年龄段有消化道症状患者的幽门螺杆菌（Hp）感染情况.方法 选取本院门诊及住院有慢性上腹疼痛、反复上消化道出血等消化道症状的患者共2275例,年龄2 ～88岁,男1058例,女1217例.采用13C-尿素呼气试验的检测方法,分析幽门螺杆菌感染的检测结果.结果 2275例患者中,13C-尿素呼气试验阳性者928例,占40.79％.男性患者,阳性414例,占39.13％;女性患者,阳性514例,占42.23％,女性高于男性（P＜0.01）.各全年龄段中,以31 ～45岁年龄组幽门螺杆菌感染率为最高,阳性333例,占48.40％.成人各年龄段与15岁以下年龄组相比,HP感染率差异有统计学意义（P＜0.01）.结论 对31 ～45岁年龄段的人群应给予关注,同时应通过健康教育提高人们的相关知识水平,有针对性地开展Hp筛查,早诊断、早治疗,从而有效预防和控制胃部疾病的发生.     

85例幽门螺杆菌感染并发胃溃疡治疗效果观察

幽门螺杆菌（Hp）感染是引起消化性溃疡的重要病因之一,国内有关调查显示Hp感染者其溃疡发生率约为13％～23％,显著高于不伴Hp感染者;实践证明根除Hp可有效治愈消化性溃疡,缩短溃疡愈合的时间。我院消化内科自2008年3月至2009年8月收治85例由于幽门螺杆菌感染而并发的胃溃疡患者,本文探讨埃索镁拉唑与奥美拉唑治疗幽门螺杆菌感染并发胃溃疡病的疗效。     

胃蛋白酶原与幽门螺杆菌感染相关性研究

为研究血清胃蛋白酶原亚群（pepsinogen,PG）含量在幽门螺杆菌感染人群血清中的含量及其临床意义,应用酶联免疫吸附实验（ELISA）,对34名正常人、51例幽门螺杆菌阳性者进行血清胃蛋酶原亚群（PGⅠ、PGⅡ）含量测定,并观察PGⅠ/PGⅡ比值变化。Hp阳性组血清与Hp阴性组血清PGⅠ值比较无显著性差异。Hp阳性组血清与Hp阴性组血清PGⅡ值进行比较有显著性差异。Hp阳性组与Hp阴性组PGⅠ/PGⅡ值比较差异非常显著。Hp阳性组血清PGⅡ升高和PGⅠ/PGⅡ比值的降低,是胃癌发生的危险因素,因此血清胃蛋白酶原检测可以作为人群筛查和辅助诊断胃癌的一项血清学指标。     

抗幽门螺杆菌单克隆抗体与人血小板交叉识别的实验研究

目的：研究抗幽门螺杆菌（Hp）尿素酶B（ureB）单克隆抗体与血小板膜糖蛋白（GP）的结合情况。方法：运用Western blot、流式细胞术（FCM）和免疫放射法（IRMA）分析血小板膜GP成分与幽门螺杆菌ttreB成分的相关性。结果：抗幽门螺杆菌ureB单抗1F11与血小板成分GPⅢa、P-选择素有一定程度结合，但与GPIb、GPⅡb及GPⅥ无结合。结论：血小板成分GPⅢa、P-选择素与幽门螺杆菌ureB存在交叉识别的共同抗原表位，提示Hp感染与部分特发性血小板减少性紫癜（ITP）的发病机理有关。     

Evaluation of the Helicobacter pylori stool antigen (HpSA) test in routine clinical practice--is it patient-friendly?

A new immunoassay has been developed to detect the presence of Helicobacter pylori antigens in stool specimens. The aim of our study was to assess the accuracy and utility of the H. pylori stool antigen (HpSA) test in routine clinical practice. Dyspeptic patients undergoing endoscopy were studied. H. pylori status was defined before treatment by CLOtest and histology, and by 13C urea breath test (UBT) after eradication therapy. A standard universal container was provided for stool collection and the HpSA test was performed by an investigator blind to the results of the other diagnostic tests. Patients also provided a venous blood sample prior to endoscopy for H. pylori serology. Sixty patients (30 M : 30 F: mean age 47 yr) were enrolled in the study. The pretreatment sensitivity, specificity, positive and negative predictive value of the HpSA test were respectively, 93%, 94%, 96%, and 90%. Twenty five patients returned for post treatment 13CUBT, but only 14 (56%) provided a stool sample for analysis. The post treatment sensitivity, specificity, positive and negative predictive value of the HpSA test were respectively, 67%, 100%, 67%, and 92%. The HpSA test was negative in 19% of the patients found positive for anti-H. pylori antibodies on serology testing. All H. pylori antibody-negative patients had a negative HpSA test. Our results suggest that the HpSA test provides accurate pretreatment diagnosis of H. pylori infection but the reliability of the test after treatment is uncertain. A potential problem with the HpSA test appears to be patient reluctance about stool handling and this could prove a significant obstacle to patient compliance and the acceptability of the test in everyday clinical practice.     

Evaluation of [13C]urea breath test and Helicobacter pylori stool antigen test for diagnosis of H. pylori infection in children from a developing country

The [(13)C]urea breath test ((13)C-UBT) and Helicobacter pylori stool antigen test (HpSA) for the diagnosis of H. pylori infection in children were validated. The sensitivity, specificity, and positive and negative predictive values were 93.8, 99.1, 97.8, and 98.0%, respectively, for the (13)C-UBT and 96.9, 100, 100, and 98.0%, respectively, for HpSA. Both tests are appropriate for diagnosing H. pylori infection in children.     

Posttreatment follow-up of Helicobacter pylori infection using a stool antigen immunoassay.

The Helicobacter pylori stool antigen enzyme immunoassay (HpSA) was evaluated during posttreatment follow-up of patients in a country with a very high prevalence of H. pylori infection. From among 273 dyspeptic individuals (18 to 55 years) initially recruited from a shantytown in Lima, Peru, 238 participants who met the inclusion criteria and were suspected to be H. pylori positive based on (14)C urea breath test (UBT) results underwent endoscopy. Participants with endoscopy-proven infections received standard eradication therapy and were monitored by UBT and HpSA at 1 month following treatment and at 3-month intervals for 9 months posttreatment. A second endoscopy was performed if UBT results showed evidence of treatment failure or H. pylori recurrence. Biopsy results were considered the "gold standard" in all analyses. Among patients who underwent endoscopy, HpSA had a pretreatment sensitivity of 93%. Two-hundred thirty patients completed the treatment regimen, of whom 201 (93%) were considered to have had successful treatment outcomes based on a negative follow-up UBT. Thirty-two patients with UBT-defined treatment failures or H. pylori recurrences at any point during the 9-month follow-up underwent a second endoscopy. In the posttreatment setting, HpSA had an overall sensitivity of 73% and a specificity of 67%. Agreement between UBT and HpSA diminished throughout the follow-up. Among 14 participants in whom HpSA remained positive at 1 month following treatment despite UBT evidence of treatment success, 12 (86%) became HpSA negative within 3 months posttreatment. Although this study confirmed the validity of the HpSA in the initial assessment of dyspeptic patients, the test demonstrated a reduced overall accuracy in the detection of treatment failures and H. pylori recurrences during 9 months of posttreatment follow-up. Furthermore, in some patients it may take up to 3 months after successful eradication for antigen shedding to diminish to levels within the negative HpSA range.     

Detection of Helicobacter pylori antigen in stool by enzyme immunoassay

Invasive techniques for diagnosis of Helicobacter pylori (H. pylori) infection require an endoscopic examination which is expensive and inconvenient and may cause complications. Stool cultures for H. pylori or a direct detection of H. pylori antigen in stools by PCR are expensive, tedious, and have a low sensitivity. We recently used an enzyme immunoassay (EIA) to detect H. pylori antigen in stool specimens. A total of 41 patients were seen at Inha University Hospital, Inchon, Korea between September and October 1998. There were 26 men and 15 women who had an average age of 37.6 years which ranged from 5 to 71 years in the present study. All of these patients came to the hospital complaining of an upper abdominal discomfort and were subjected to endoscopy and biopsies. Fifteen had a gastric ulcer, 13 had a duodenal ulcer, 1 had an early gastric cancer, and there were 12 chronic gastritis patients as shown by endoscopy. The biopsy specimens were examined by histology, CLO test, and cultures and these results were used as gold standards. Stool specimens were tested for the H. pylori antigen by EIA. A dual wavelength cut-off of 0.100 that was recommended by the manufacturer gave a good performance (87.1% sensitivity, 100% specificity, 100% positive predictive value, 71.4% negative predictive value, and a 90.2% efficiency). But the adjusted cut-off value using the receiver operating characteristic curve improved the performance of the test (using the cut-off value of 0.024, the sensitivity, specificity, PPV, NPV, and efficiency were 100%, 90.0%, 96.9%, 100%, and 97.6% respectively). Re-evaluation of the cut-off value may be needed for Korean patients. This technique is non-invasive, rapid, easy-to-use, and shows good performance characteristics for diagnosis of H. pylori infections. Therefore, this technique may be a substitute for gastric endoscopy especially in children and some patients who are unable to tolerate an endoscopic examination and it may be substituted for a serologic test in epidemiological research.     

Detection of Helicobacter pylori antigen in faeces by enzyme immunoassay

The detection of Helicobacter pylori antigen directly in faecal specimens may offer an alternative non-invasive method for determining the presence of H. pylori infection. This study compared the performance of the Premier Platinum HpSA enzyme immunoassay (HpSA) with histology and CLOtest, a rapid urease test. Of 134 patients undergoing upper gastrointestinal endoscopy, 37 (28%) were H. pylori-positive by histology and CLOtest. Using the HpSA test, H. pylori was detected in 35 H. pylori-positive patients (95% sensitivity) and one H. pylori-negative patient (99% specificity). The positive and negative predictive values for HpSA were 97 and 98%, respectively. HpSA is a rapid, easily performed, non-invasive method for detecting H. pylori.     

Two enzyme immunoassays and PCR for detection of Helicobacter pylori in stool specimens from pediatric patients before and after eradication therapy

This study of pediatric patients was intended to determine the suitability of stool PCR and two antigen enzyme immunoassays (EIAs; Premier Platinum HpSA and the novel FemtoLab H. pylori), which detect Helicobacter pylori antigens in feces, as pretreatment diagnostic tools and especially as posttreatment control. Forty-nine H. pylori-infected children with dyspepsia received eradication therapy. Successful treatment was determined by a negative [(13)C]urea breath test 4 and 12 weeks after discontinuation of therapy. Fecal specimens were collected prior to eradication therapy as well as 4 weeks after the end of treatment. Successfully treated children delivered stool samples at 6, 8, and 12 weeks posttreatment also. Specimens were examined by seminested PCR and Premier Platinum HpSA and were reexamined by both EIAs as soon as FemtoLab H. pylori was available. In the first test series, the overall sensitivities of PCR and Premier Platinum HpSA were 93.0 and 91.1%, respectively. With specimens collected at 4 weeks after treatment, the respective specificities were 68.8 and 79.3%. After longer follow-up periods, however, they gradually increased to 100 and 96.9%, respectively. In the new test series, Premier Platinum HpSA delivered a considerably lower number of false-positive results (4 versus 18), indicating intertest variations. The overall test sensitivity was 94.6%, and the overall specificity was 97.5%. FemtoLab H. pylori showed an excellent performance with an overall sensitivity and specificity of 98.2 and 98.1%, respectively. Thus, in contrast to PCR, both EIAs were shown to be suitable for early posttreatment control.     

Evaluation of the novel Helicobacter pylori ClariRes real-time PCR assay for detection and clarithromycin susceptibility testing of H. pylori in stool specimens from symptomatic children

The aim of the present study was to evaluate the Helicobacter pylori ClariRes assay (Ingenetix, Vienna, Austria) for the detection of H. pylori infection and the simultaneous clarithromycin susceptibility testing of the H. pylori isolates in stool samples from 100 symptomatic children. The results obtained by this novel biprobe real-time PCR method were directly compared with the results obtained from histological examination of gastric biopsy specimens, culturing, the [13C]urea breath test, and a monoclonal antibody-based stool antigen enzyme immunoassay (EIA). Fecal specimens from all 54 children who were shown to be noninfected by "gold standard" tests gave true-negative PCR results (specificity, 100%). Of the remaining 46 individuals with a positive H. pylori status, 29 were found to be positive by real-time PCR (sensitivity, 63%). For these 29 cases, the H. pylori ClariRes assay confirmed all results from phenotypic clarithromycin susceptibility testing by Etest. In summary, this investigation demonstrates that detection of Helicobacter DNA in stool samples by real-time PCR is a difficult task and that this method cannot replace the stool antigen EIA (sensitivity, 95.7%) for the accurate diagnosis of H. pylori infection in children.     

A strain-specific antigen in Japanese Helicobacter pylori recognized in sera of Japanese children

An enzyme immuno assay (EIA) test based on Japanese strain-derived high-molecular-weight cell-associated proteins (JHM-CAP) was evaluated by comparing with a previously developed EIA test based on a U.S. strain-derived high-molecular-weight cell-associated proteins (HM-CAP). Serum samples of 131 Japanese asymptomatic children (mean age, 5.5 years; range, 0 to 21 years) were tested that include 43 positive and 88 negative children as judged by Helicobacter pylori stool antigen test (HpSA test). Both tests showed comparable and reliable specificities, but the sensitivity of JHM-CAP EIA, at 93.0%, was much higher than that of HM-CAP EIA, at 67.4%. More false-negative results of HM-CAP were obtained in children under 10 years of age. Immunoblot analysis revealed that the JHM-CAP but not the HM-CAP preparation had a 100-kDa antigen recognized by JHM-CAP positive sera. It was concluded that JHM-CAP EIA is highly accurate for the serodiagnosis of H. pylori infection in Japanese young children and that the high sensitivity of JHM-CAP EIA in contrast to HM-CAP EIA is due to the presence of a 100-kDa antigen in Japanese strains that may be recognized by the host immune system at an early stage of infection.     

Application of a stool antigen test to evaluate the incidence of Helicobacter pylori infection in children and adolescents from Tehran, Iran

Helicobacter pylori infection is acquired mainly in childhood, especially in developing countries, where a low-cost, rapid diagnostic technique which is reliable for all age groups may be useful for the management of H. pylori infection. For this purpose, we used an HpSA test (Equipar) to detect H. pylori infection in children and adolescents from Tehran, Iran. Thirty-five children who were positive or negative for H. pylori infection by endoscopy-based tests were used as positive and negative controls for the HpSA test. Stools were collected from 430 randomly selected children and adolescents (4 to 18 years old) from southwest, near the center, and northwest of Tehran. A questionnaire that included presence of recurrent abdominal pain (RAP), family history of infection and/or peptic ulcer disease (PUD), and income of parents was completed. A good agreement was found between the results of endoscopy-based tests and those of the HpSA test; the sensitivity and specificity of the Equipar-HpSA test were 100% and 83.4%, respectively. Among 430 children and adolescents, 47% were positive by the HpSA test, of whom 82% had RAP. No difference in incidence was observed between the two sexes; the various categories of age showed an increasing incidence, ranging from 24% (ages 4 to 6) to 58% (ages 16 to 18). The rate of infection in children and adolescents from the southwest was significantly higher (70%) than the rate in those from the northwest (32%), and a family history of H. pylori infection or PUD was observed in 59% of the HpSA positive subjects. The HpSA test is a useful test to detect H. pylori infection in children and adolescents from developing countries.     

Isolation and preliminary evaluation of a low-molecular-mass antigen preparation for improved detection of Helicobacter pylori immunoglobulin G antibodies.

Previously, immunoglobulin G (IgG) antibodies to five antigens with a relative molecular mass of between 15 and 30 kDa from Helicobacter pylori were found to be significantly more frequent in H. pylori-infected patients than in noninfected patients. In this study, these specific low-molecular-mass (LMW) antigens were separated by ultrafiltration of whole-cell sonicates. The LMW antigen preparation was evaluated by enzyme-linked immunosorbent assay with serum samples from 76 children with abdominal symptoms and 151 adults with dyspeptic symptoms. H. pylori was cultured or seen in 40 (53%) children and 83 (55%) adults. Increased antibody levels to H. pylori were found in serum from 35 (46%) children and 88 (58%) adults. Values for sensitivity, specificity, and predictive value of positive and negative results of the test were higher with LMW antigens than with the heat-stable antigen previously described. The low specificity and predictive value of a positive result were due to seropositive results for 21 persons with a negative culture for H. pylori and negative microscopy results for Helicobacter-like organisms in biopsies from gastric mucosa. Histologically, chronic gastritis was demonstrated in 43% of these persons, and 19% had peptic ulcer, indicating that they have or have had H. pylori infection. Specific antibodies to H. pylori were confirmed in all 21 patients by the Western immunoblot technique. Use of the LMW antigen improved the IgG antibody detection in patients with H. pylori infection, even though the results reflect the difficulties in establishing a true gold standard for diagnosis of H. pylori infection.