抗Hp-IgG检测在消化性溃疡治疗中的意义

目的：通过对检测血清抗幽门螺杆菌抗体（抗Hp-IgG）阳性的胃、十二指肠溃疡患者治疗前后抗Hp-IgC的变化观察，评价抗Hp-IgG检测在消化性溃疡治疗中的意义。方法：选择106例经胃镜检查诊断为胃或十二指肠溃疡患者，同时胃粘膜活检标本快速尿素酶试验、涂片染色联合检测Hp作为“金标准”，“金标准”阳性者为Hp感染的治疗观察对象。结果：服药2周后检查平均Hp清除率为75．65％，其中十二指肠球部溃疡为77．8％（56／72）、胃溃疡73．5％（25／34）溃疡愈合率为41．3％，其中十二指肠球部溃疡44．4％（32／72），胃溃疡38．2％（13／34）。治疗4周后溃疡愈合率为93．5％，其中十二指肠球部溃疡为95．8％（69／72），胃溃疡为91．2％（31／34），Hp清除率达93％。结论：检测血清中抗Hp- gG可以了解Hp清除情况．以指导临床用药，用于Hp根除后的随访。     

儿童无症状幽门螺杆菌感染状况研究

目的：研究无上消化道症状儿童幽门螺杆菌感染（Helicobactor pylori,Hp)感染状况。方法：采用^13C尿素呼吸试验（^13C-Urea Breath Test,^13C-UBT)及血清ELISA法检测Hp-IgG。结果：133例儿童。男54例女79例,^13C-UBT及Hp-IgG的阳性纺分别为9．8％,34．65;其中,2－6岁51例,^13C-UBT及Hp-IgG的阳性率分别为7．8％和29．4％;6－10岁82例,^13C-UBT及Hp-IgG的阳性率分别为11％和37．8％,两个年龄组间感染率无统计学差异,性别也无差异,P＞0．05。结论：（1）无上消化道症状儿童Hp感染状况不容忽视;（2）^13C-UBT检测无症状儿童Hp感染状况方法简单、安全、快速且准确性高。不检测Hp无症状感染的有效手段。     

检测幽门螺杆菌感染的几种方法的评估比较

目的通过对几种幽门螺杆菌检测方法的灵敏性和特异性进行比较，为临床提供一种检测幽门螺杆菌的最佳方案。方法分别用快速尿素酶试验（RUT）、胃窦黏膜Giemsa染色、血清Hp抗体检测及C^13-尿素呼气试验检测患者的Hp感染情况，并计算敏感性及特异性等。结果在145例有慢性中上腹疼痛，反复脐周及上消化道出血等消化道症状者中尿素酶试验（RUT）、胃窦黏膜Giemsa染色、血清Hp抗体检测及C^13-尿素呼气试验检测患者Hp的感染的敏感性分别为94．4％、95．5％、91．0％、96．6％，特异性分别为66．1％、100．0％、75．0％、100．0N。结论C^13-尿素呼气实验检测Hp，既用于诊断，也适用于根除治疗的监测，易为患者接受，是较理想的检查方法，值得临床推广应用。     

幽门螺杆菌感染与脑梗死的关系

目的：研究幽门螺杆菌（Hp）感染与脑梗死（CI）的关系。方法：90例CI患者作为脑梗死组，92例正常体检者作为对照组。检测两组的血清耶特异性抗体（Hp—IgG）、C反应蛋白（CRP）、血脂及纤维蛋白原（Fbg）水平。并将Hp-IgG阳性的68例CI患者，分为抗Hp治疗组（A组）与非抗脚对照组（B组），两组均给予常规的降纤、溶检和神经细胞营养治疗，而A组再加用一共7d的阿莫西林、奥美拉唑、胶体果胶铋和甲硝唑的抗蛳治疗，两组于治疗后再分别检测CRP、血脂和Fbg.结果：脑梗死组的血清Hp-IgG的阳性率（75．5％）明显高于对照组（42．4％），脑梗死组的Hp—IgG、 CRP、甘油三酯（TG）及Fbg水平明显高于对照组（P〈0．01）．脑梗死组中Hp-IgG阳性患者的TG、低密度脂蛋白（LDL）及Fbg水平也高于Hp-IgG阴性患者（P〈0．05），A组抗Hp治疗后的CRP、TG、LDl．及Fbg水平有明显下降（P〈0．01）。结论：脚感染与CI相关。建议对Hp阳性的CI患者使用短期安全的抗Hp治疗.[著者文摘]     

幽门螺杆菌感染及血清同型半胱氨酸水平与不同年龄脑梗死关系的研究

目的通过观察青年及老年脑梗死患者血清幽门螺杆菌（Hp）IgG（Hp-IgG）抗体及Hp细胞毒素相关蛋白A抗体IgG（CagA-HplgG）的阳性率及血清同型半胱氨酸（HcY）浓度,探讨Hp感染及血浆HcY与不同年龄脑梗死的关系。方法应用酶联免疫吸附测定法检测青年（〈45岁）、老年（〉60岁）脑梗死患者各40例血清Hp—IgG、CagA—Hp-IgG及血HCY浓度;同时检测血清总胆固醇（TC）、甘油三酯（TG）、载脂蛋白A（ApoA）,载脂蛋白B（ApoB）。结果老年组血浆Hp-IgG及CagA-Hp-IgG阳性率显著高于青年组75．0％vs52．6％,65．0％vs37．5％（P〈0．05）;青年组血浆HCY平均浓度明显高于老年组（48．6±9．5）μmol／Lvs（35．6±7．1）μmol／L（P〈0．01）,两组之间血脂水平除TG外（P〈0．01）,差异均无统计学意义（P〉0．05）。结论HP感染与老年脑梗死的发病较青年脑梗死更为密切,并可能影响血TG水平,而血清HCY与青年脑梗死发病更为密切。     

患儿粪便中幽门螺杆菌抗原及血清抗体检测

幽门螺杆菌（Hp）是小儿慢性胃炎、十二指肠炎及消化性溃疡的重要病因之一。临床检测Hp的方法较多，传统多采用侵入性内镜检查法，此法准确性、特异性较高，是诊断Up感染的金标准，但儿童、老人及孕妇难以接受。非侵人性方法有^13C尿素呼气试验（^13C-UBT）、粪便中Hp抗原（HpSA）检测及血清抗体（Hp—IgG）检查等。本研究通过对153例患儿HpSA、Hp-IgG的检测，与金标准进行了对比分析，并对36例Hp阳性患儿根治后进行了^13C-UBT检测，复查了HpSA、Hp-IgG，且进行了对比分析。     

幽门螺杆菌粪便抗原检测法在幽门螺杆菌根除后患者中的效果

目的：探讨幽门螺杆菌（Hp）粪便抗原检测（HpSA）在Hp根除后患者中的效果,为Hp感染患者后期复查提供依据。方法选取该院2011年12月至2013年12月进行Hp根治后的170例患者进行研究,所有患者均进行14C尿素呼气试验检测HpSA,观察HpSA检测Hp的灵敏度和准确率,为Hp感染的检测提供依据。结果与14C尿素呼气试验金标准检测比较,患者治疗1周后,HpSA试验检测灵敏度为78．08％,诊断正确率为68．24％;患者治疗2周后HpSA试验检测灵敏度为74．12％,诊断正确率为54．71％;患者治疗3周后,HpSA试验检测灵敏度为46．38％,诊断正确率为47．65％。结论HpSA检测方法的诊断准确率高、灵敏度高、特异度高、适用于Hp的诊断,尤其适用于儿童、老年患者的筛查及无法开展13C或14C‐尿素呼气试验的贫困地区,且检测值不受患者是否进行治疗的影响。     

尿幽门螺杆菌抗体测定在幽门螺杆菌感染诊断中的价值

目的：探讨幽门螺杆菌（Hp)抗体阴性用于排除近期Hp感染的临床价值。方法：Hp感染诊断采用^13C尿素呼气试验、快速尿素酶试验和W－S银染色，Hp抗体测定采用Hp抗体测定层析板。结果：31例Hp感染患10分钟阳性率87．1％（27／31），30分钟阳性率96．7％（30／31），56例无Hp感染患假阳性率19．7％（11／56）。对Hp感染诊断敏感性96．78％，特异性80．3％。对Hp感染阳性组以Hp抗体，^13C尿素呼气试验阳性率最高，Hp感染阴性组以Hp抗体阳性率最高。46例阳性病例中仅1例^13C尿素呼气试验阳性，W－S银染色、快速尿素酶试验均阴性。结论：Hp抗体阴性基本可排除近期有Hp感染，可避免病人作进一步的无益检查。     

肺癌与幽门螺杆菌感染相关性研究

目的探讨肺癌与幽门螺杆菌（Hp）感染的关系。方法用酶联免疫吸附试验（ELISA）检测方法，对50例肺癌患者和50例非肿瘤患者进行血清幽门螺杆菌血清学抗体（Hp-IgG）和幽门螺杆菌细胞毒素相关蛋白抗体（Hp-CagA-IgG）检测。结果①肺癌组Hp-IgG阳性率92．0％，平均抗体水平250．714U／ml。显著高于对照组的阳性率44．0％（P〈0．01）和平均抗体水平77．674U／ml（P〈0．01）。②肺癌组Hp-CagA-IgG阳性率88．0％，显著高于对照组的阳性率20．0％（P〈0．01）。③鳞癌Hp-IgG平均水平（322．10U／ml），明显高于腺癌和小细胞癌（163．92U／ml、196．66U／ml）（P〈0．05）。结论肺癌与Hp感染密切相关，鳞癌平均Hp-IgG水平明显高于腺癌和小细胞癌。     

幽门螺杆菌感染对冠心病患者高半胱氨酸和C反应蛋白的影响

目的 探讨幽门螺杆菌(Hp)感染对冠心病（CHD）患者血清高半胱氨酸（Hcy）和C反应蛋白（CRP）的影响,探讨其与CHD的关系。 方法 应用酶联免疫吸附试验法测定152例CHD患者和101例健康体检者血清抗Hp抗体（抗Hp-IgG）,同时进行血清CRP和Hcy的检测,并对抗Hp-IgG阳性组与抗Hp-IgG阴性组进行对比分析。 结果 CHD组血清抗Hp-IgG阳性率明显高于非CHD组（P<0.05）;CHD组Hcy、CRP含量显著高于对照组（P<0.05）,且随着病情进展,Hcy、CRP含量逐渐增高;抗Hp-IgG阳性的CHD患者血清Hcy、CRP 浓度也明显高于抗Hp-IgG阴性CHD组（P<0.05）。 结论 Hp感染诱发炎症使Hcy、CRP水平升高,并促进冠心病发展。     

Helicobacter pylori stool antigen test

In Japan, Helicobacter pylori stool antigen(HpSA) test was opened for diagnosis of H. pylori infection before and after eradication therapy form Nov. 1, 2003. We can use two kinds of HpSA kits, Premier Platinum HpSA(Meridian Bioscience, USA) and Testmate pylori antigen EIA(Wakamoto Pharmaceutical Co., Ltd., Japan). We evaluated the diagnostic accuracy of the HpSA test(Premier Platinum HpSA) compared with diagnosis based on endoscopic biopsy-based methods. In 136 patients, the sensitivity and specificity of the HpSA test before therapy were 98.3% and 95.0%, respectively. In 54 patients, the sensitivity and specificity of the HpSA test after eradication therapy were 90% and 97.7%, respectively. Therefore, it is concluded that the HpSA test is a useful method for the diagnosis of H. pylori infection before and after eradication therapy.     

Diagnosis of Helicobacter pylori infection

Peptic ulcer in elderly patients may be associated with Helicobacter pylori infection. Diagnosis for H. pylori infection should be needed in these patients. The test may be resulted in false negative in case of invasive diagnostic methods based gastric biopsy, because atrophic gastritis and intestinal metaplasia developed in patients may not be able to detect scarce infection of the bacterium. Urea breath test or stool antigen test are recommended for diagnosis of H. pylori infection in patients. It is suitable for patients, because of the non invasive nature of these diagnostic tests.     

Helicobacter pylori eradication therapy for gastric ulcer in elderly

Sixty-five-years or older person accounts for 23% of the population in Japan. Hence, Helicobacter pylori (H. pylori) eradication therapy is performed in many elderly patients. Urea breath test and H. pylori stool antigen test for diagnosis of H. pylori infection before and after eradication therapy are recommended from the point of being a noninvasive test and providing accurate diagnosis. H. pylori eradication therapy in Japan consists of the PPI/AMPC/CAM as the first therapy, and PPI/AMPC/MNZ as the second therapy. Eradication therapy rate and adverse effect rate of H. pylori eradication therapy for elderly patients are the same as for young people. It is not necessary to avoid H. pylori eradication therapy merely because of high age in elderly patients. However, it is necessary to be careful regarding drug interactions in patients who are taking multiple drugs.     

粪便抗原检测对幽门螺杆菌感染的诊断价值

目的：研究幽门螺杆菌粪便抗原（HpSA）检测诊断幽门螺杆菌（HP）感染的临床应用价值。方法：采用ELISA法检测98例因上消化道症状接受胃镜检查病人的HpSA,同时进行细菌培养,快速尿素酶试验和^14C－尿素呼气试验检查。将后三项检查中二项阳性或细菌培养一项阳性作为诊断HP感染的金标准。结果：金标准诊断HP感染,阳性54例,阴性44例。金标准阳性的54例中,HpSA检测阳性为51例,阴性为3例;金标准阴性的44例中,HpSA检测阴性为42例,阳性为2例。HpSA检测诊断HP感染的敏感度94．4％（51／54）,特异度95．5％（42／44）,准确度94．9％（93／98）,阳性预测值96．2％（51／53）,阴性预测值93．3％（42／45）。结论：HpSA检测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。     

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.     

The clinical applications and accuracy of 2 rapid near-patient tests in detecting Helicobacter pylori infection

Noninvasive methods for assessing Helicobacter pylori infection status are now an integral part of managing patients with upper gastrointestinal complaints. The aim of this study is to evaluate the feasibility and diagnostic accuracy of 2 rapid tests: a urine-based H. pylori antibody detection method (Rapirun) and a stool-based H. pylori antigen detection method (immunocard STAT! HpSA). The combined use of the mentioned 2 tests was also evaluated, which has not been described in previous similar studies. Urine and stool specimens were collected from patients who were arranged for gastroendoscopic examination. The urine and stool specimens were tested with Rapirun and immunocard STAT! HpSA separately. The estimated reaction time was about 15 to 20 min for the former and 5 to 10 min for the latter. H. pylori infection was confirmed with 4 tests: culture, histology, rapid urease test, and the (13)C-urea breath test. Obtained results from both kits were compared with confirmed results. One hundred twenty patients were eligible for analysis. Of them, 62 tested positive for H. pylori infection and 58 were negative by the confirmation criteria. The urine Rapirun test relative to the confirmed results showed sensitivity, specificity, and accuracy as 87.1% (confidence interval [CI] = 81.1-93.1%), 89.7% (CI = 84.2-95.1%), and 88.3%, respectively. The stool immunocard STAT! HpSA test relative to the confirmed results showed sensitivity, specificity, and accuracy as 96.8% (CI = 93.6-99.9%), 82.8% (CI = 76.0-89.5%), and 90%, respectively. The combined-use method of both tests revealed sensitivity, specificity, and accuracy as 98.4% (CI = 96.1-100%), 81.0% (CI = 74.0-88.1%), and 90%, respectively. These 2 urine and stool tests have a satisfactory accuracy around 90% in detecting H. pylori infection. In consideration of the advantages of cheapness, timesaving, and ease of use, both can be used as rapid near-patient tests in general practice. The combined use of both tests was also promising in detecting H. pylori infection.     

Helicobacter pylori infection in intensive care: increased prevalence and a new nosocomial infection.

OBJECTIVE: The pathogenesis of acute gastric stress ulceration in the seriously ill is uncertain, and any role of Helicobacter pylori infection is unknown. We aimed to assess the relationship between H. pylori serological status and stress ulceration in seriously ill patients, as well as H. pylori serological status in intensive care nurses as a marker for nosocomial infection. DESIGN: Prospective epidemiologic survey. SETTING: Adult intensive care unit in a university teaching hospital. PATIENTS: One hundred patients, 100 nurses, and 500 blood donors as community controls. INTERVENTIONS: H. pylori serological status was measured in patients, staff, and controls using a rapid whole blood test. Upper gastrointestinal bleeding and risk factors for acute stress ulceration were recorded. MEASUREMENTS AND MAIN RESULTS: In seriously ill patients, H. pylori seropositivity (67%) was significantly higher than in the control group (39%) (p < .001). In patients, seropositivity was not related to age, country of birth, diagnostic category, severity of illness, or risk score for stress ulceration. There was a trend toward increased macroscopic gastric bleeding in seropositive patients. In intensive care nurses, H. pylori seropositivity (40%) was significantly higher than in age-matched controls (19%) (p < .001). Only duration of intensive care nursing was significantly associated with seropositivity (p = .02). CONCLUSIONS: The unexpectedly high H. pylori seropositivity rate in this seriously ill cohort raises the possibility that under intensive care conditions, H. pylori infection may modulate responses to illness and injury, with consequent clinical implications. Furthermore, the elevated seropositivity rate in intensive care nurses suggests that H. pylori can be nosocomially transmitted.     

Comparison of stool antigen immunoassay methods for detecting Helicobacter pylori infection before and after eradication treatment

The aim of the study was to compare 6 stool antigen immunoassays for detecting Helicobacter pylori before and after eradication treatment. We compared 3 enzyme immunoassay (EIA) and 3 monoclonal immunochromatographic assays in diagnosing infection and in determining H. pylori status after eradication treatment. We evaluated stool samples from 80 patients diagnosed with H. pylori infection and from 18 patients without infection. To confirm H. pylori eradication, we evaluated 40 patients who received H. pylori treatment. The sensitivity and specificity were 87.3% and 83.3% for Immundiagnostik ELISA, 92.5% and 72.2% for HpSA EIA test, 95% and 66.6% for HpStAR EIA, 83.8% and 66.6% for H. pylori Letitest, 52.5% and 94.4% for ImmunoCard HpSA, and 78.8% and 55.5% for RAPID HpStAR, respectively. From the 40 patients evaluated 6 weeks after eradication therapy, the best agreement between the urea breath tests and immunoassay tests was with HpStAR EIA (90%) and H. pylori Letitest (85%). HpStAR EIA and H. pylori Letitest could be used as a routine diagnostic tool in the microbiology laboratory for assessing clinical significance and eradication control of H. pylori infection.     

Evaluation of three commercial enzyme-linked immunosorbent assay kits for diagnosis of Helicobacter pylori in Chinese patients.

Most of the commercial serological assays for H. pylori are developed and validated in western countries. We evaluated the accuracy of three popular commercial ELISA tests for H. pylori in the Chinese population. Eighty dyspeptic patients were recruited and diagnosis of H. pylori infection was based on biopsy urease test, histology and urea breath test. Thirty-six patients (45%) were positive for H. pylori infection by two or more positive reference tests. Anti-H. pylori IgG antibody was detected by three commercial ELISA tests: GAP IgG (Bio-Rad), HM-CAP (Enteric Products) and Pyloriset EIA-G (Orion). The respective sensitivity, specificity, positive and negative predictive values of the three tests were: GAP IgG (50%, 97.4%, 93.8%, 71.7%), HM-CAP (72.7%, 68.4%, 66.7%, 74.3%) and Pyloriset EIA-G (75%, 86.4%, 81.8%, 80.9%). Despite the high accuracy reported in the West, the performance of these commercial serological tests was unsatisfactory when used in Chinese patients.     

Suitable diagnostic methods for H. pylori infection after eradication therapy

Urease test, histology, culture, urea breath test(UBT) and stool antigen test are accurate tests for Helicobacter pylori diagnosis. General practitioners are now going to test peptic ulcer disease patients with these tests before and after in Japan. To test with high accuracy after eradication therapy, it is important that examination should be done over 4 weeks after cessation of treatment with PPI and antibiotics. UBT and stool antigen test are suitable tests for diagnosis of Helicobacter pylori infection after treatment.