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.     

血清幽门螺杆菌抗体定量检测的临床价值

目的:分析体检人群幽门螺杆菌(HP)感染情况,并依据评价血清HP抗体定量检测的临床价值。方法:选取2019-10—2019-11于湖北省人民医院体检的405例体检者为研究对象,并根据尿素~(14)C呼气试验结果分为阳性组(n=223)和阴性组(n=182)。采用聚胶免疫比浊法法检测血清中HP抗体含量,以尿素~(14)C呼气试验结果为标准,评价血清HP抗体定量检测的敏感度、特异度、阳性预测值和阴性预测值。结果:体检人群中尿素~(14)C呼气试验的阳性率为55.6%,与阴性组相比,阳性组中血清HP抗体含量显著升高(P<0.01)。在尿素~(14)C呼气试验阳性的223例受试者中,其血清HP抗体定量检测阳性的例数为193,该检测敏感度为86.55%;在尿素~(14)C呼气试验阴性的182例受试者中,血清HP抗体定量检测阴性的例数为138,该检测的特异度为75.82%。血清HP抗体定量检测阳性预测值为81.43%,阴性预测值为82.14%。结论:血清抗体定量检测与尿素~(14)C呼气试验结果一致性较好,或可补充尿素~(14)C呼气试验的不足,更好地辅助临床诊断。     

13C-尿素呼气试验诊断幽门螺杆菌感染

幽门螺杆菌(HP)是慢性胃炎、消化性溃疡病的主要致病因素,且与胃癌的发生亦相关[1,2].目前诊断幽门螺杆菌感染的金标准为13C-尿素呼气试验[3,4].本文应用稳定性同位素13C-尿素呼气试验及胃粘膜病理切片HP染色,分别对96例慢性胃炎、37例胃溃疡和32例正常对照者进行测定,并对这两种HP感染检查的结果进行对比.     

^13C-尿素呼气试验检测HP感染的意义

目前可用于诊断幽门螺杆菌(HP)感染和疗效评价的方法很多,以内镜下取胃黏膜行组织学检查及快速尿素酶试验为诊断HP感染的金标准,将13C-尿素呼气试验(13C-UBT)结果与其比较,以评价13C-UBT对HP感染的诊断价值.     

14C-尿素呼气试验与PCR法对胃幽门螺杆菌感染诊断价值的比较

目前诊断胃幽门螺杆菌(HP)的方法很多,其中14C-尿素呼气试验(14C-UBT)及聚合酶链反应(PCR)对胃HP感染的诊断价值得到公认,报道较多,我们对部份患者同时进行上二项检查,并对结果进行了比较,报告如下:     

^14C—尿素呼气试验与PCR法对胃幽门螺杆菌感染诊断价值？…

目前诊断胃幽门螺杆菌(HP)的方法很多,其中14C-尿素呼气试验(14C-UBT)及聚合酶链反应(PCR)对胃HP感染的诊断价值得到公认,报道较多,我们对部份患者同时进行上二项检查,并对结果进行了比较,报告如下:     

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.     

HP检测在上消化道疾患中诊断价值的探讨

本文对 5 5 8例上消化道疾患的病人用14 Ｃ -尿素呼气试验进行了幽门螺杆菌 (ＨＰ)感染率的检测。结果表明十二指肠球部溃疡阳性率为 86 % ;慢性浅表性胃炎阳性率为 70 % ;浅表萎缩性胃炎阳性率为 49% ;糜烂性胃窦炎阳性率为47 4% ;慢性胃窦炎阳性率为 38% ;提示了14 Ｃ -尿素呼气试验对ＨＰ感染的检测有一定的临床诊断价值。材料和方法一、对象 :标本采自我院从 2 0 0 0年 1月～ 2 0 0 1年 1月期间 ,来消化科门诊和住院应各种消化道症状就诊的患者 ,并经内窥镜检查确诊为消化道疾病的 5 5 8例患者 ,进行了14 Ｃ -尿素呼气试验。其中男性 32…     

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.     

上海地区电力员工体检幽门螺杆菌检测结果分析

目的了 解上海地区电力员工体检人群幽门螺杆菌(helicobacter pylori,Hp)感染情况及分布特征,为本地区电力员工幽门螺杆菌的预防与治疗提供科学依据.方法 选取2015年1月至12月本院健康体检者58876名,以性别和年龄进行分组,应用13C尿素呼气试验(13C-ureabreath test,13C-UBT)快速检测体检人群中幽门螺杆菌感染情况,并对其结果进行统计学分析.结果 58876名体检者幽门螺杆菌总感染率为42.4％ (24942/58876),其中男性和女性感染率分别为43.9％(18868/43025)和38.3％ (6074/15851),差异具有统计学意义(P＜0.05);不同年龄感染情况:低年龄组(≤30岁)感染率为37.6％ (2805/7460),中年龄组(31～60岁)为43.5％(18428/42397),高年龄组(＞60岁)为41.1％ (3709/9019),每组之间差异均具有统计学意义(P＜0.05).结论 上海地区电力员工体检幽门螺杆菌感染分布与年龄、性别都有关.     

13C-尿素呼气试验诊断幽门螺杆菌的临床应用

应用13C-尿素呼气试验(13C-UBT)评估胃镜常规检查幽门螺杆菌(HP)显示为阴性的患者的HP感染情况及根除HP的治疗效果。选择胃镜组织检查及快速尿素酶试验HP阴性的胃肠道疾病患者,以非胃肠道疾病患者为对照组,行13C-UBT检测。对13C-UBT检测HP阳性病例施行根除治疗,治疗后行13C-UBT复查,作为评价疗效指标。结果640例胃镜常规检查HP阴性的患者中,有389例13C-UBT结果为HP阳性,阳性率60.8%。对13C-UBT检测HP阳性病例分别施行PPI三联、PPI二联、单纯PPI治疗,其转阴率分别为83.8%,18.4%,3.3%。三种治疗方案之间有显著性差异(P<0.05)。对于胃镜常规检查显示HP阴性的病例中,应用13C-UBT有助于提高检出率和疗效判断。     

口臭患者14C呼气试验检测的结果分析

目的探讨口臭与幽门螺旋杆菌及其它因素的关系。方法对59名正常组、50例单纯口臭组患者、56例口臭伴消化道疾病组患者14C呼气试验的结果进行分析。结果分析结果表明,口臭伴消化道疾病组14C呼气试验含量明显高于单纯口臭组和正常组(P0.05),阳性率也明显高于单纯口臭组和正常组(P0.05)。结论幽门螺旋杆菌感染是口臭的重要原因,但不是唯一原因。     

Role of vacA and cagA in Helicobacter pylori inhibition of mucin synthesis in gastric mucous cells

The aim of this study was to investigate the effect of Helicobacter pylori on the function of gastric mucous cells. H. pylori (10(4) to 10(7) CFU/well) was incubated with the mucin-producing gastric cell line HM02 for 12 and 24 h. Mucin synthesis and secretion were determined by the incorporation of D-N-[acetyl-(14)C]glucosamine into intracellular and released high-molecular-weight glycoproteins. cagA-positive, cytotoxin-producing and non-cytotoxin-producing H. pylori strains impaired the incorporation of D-N-[acetyl-(14)C]glucosamine into intracellular glycoproteins. Significant inhibition of mucin synthesis was noted after 12 and 24 h of cocultivation with a bacterial load of >/=10(5) bacteria (bacterium/cell ratio = 0.25). The cagA-positive, cytotoxin-producing strains (HP64, HP57, and HP87) caused significantly stronger inhibition of intracellular mucin synthesis than the cagA-positive, non-cytotoxin-producing strains (HP05, HP83, and HP84). The cagA-negative, non-cytotoxin-producing strains (HP01, HP04, and HP85) did not affect intracellular mucin synthesis. The results indicate that H. pylori directly impairs mucin synthesis in gastric mucous cells and that cytotoxic cagA-positive strains cause more profound inhibition of mucin synthesis. We suggest that the increased inhibitory effect of cagA-positive, cytotoxin-producing strains on mucin synthesis can be considered one possible factor responsible for the increased risk of developing peptic ulceration with these H. pylori strains.     

体检人群胃蛋白酶原水平分析及异常结果处理对策

目的 分析健康体检人群的血清胃蛋白酶原(PG)水平及其影响因素,并对PG异常者的处理对策进行初步探讨.方法 选择太湖干部疗养院健康体检人员531名为对象,用时间分辨荧光免疫分析法(TRFIA)检测血清PG值,使用13C尿素呼气试验(13 C-UBT)检测该人群的幽门螺杆菌(HP)感染率,并调查分析影响PG水平的相关因素...     

Point-of-care Helicobacter pylori urine antibody detection in a multi-ethnic adult population in the United States

A need exists for accurate point-of-care tests for diagnosis of Helicobacter pylori (H. pylori) infection to evaluate a rapid urine-H. pylori antibody test device for detection of H. pylori infection in a point-of-care setting in the United States. A multi-center study in a multi-ethnic population compared the RAPIRUN urine antibody test with the (13)C-urea breath test (C-UBT) and a traditional serologic test, the high-molecular-weight cell-associated protein enzyme immunoassay (HM-CAP EIA). The primary comparator was with "definite positive" and "definite negative" patients defined as a concordance of combined results of the UBT and the HM-CAP IgG EIA. Overall, 188 eligible patients were enrolled (61 men, age range: 18-73 years, including 84 Hispanics, 73 Asian-Pacific Americans, 22 Black African-Americans, 6 non-Hispanic Caucasians, and 3 of "other" ethnicity). Compared with "definite positive" and "definite negative" results, the sensitivity and specificity of the urine antibody test were 0.9 and 1.0, respectively. The urine antibody test proved suitable for point-of-care rapid diagnosis of anti-H. pylori antibodies indicative of active or past H. pylori infection.     

Circulating cytokines and gastrin levels in asymptomatic subjects infected by Helicobacter pylori (H. pylori)

The pathophysiology of hypergastrinemia in H. pylori infection has been largely investigated and different reports clearly show that the infected antrum has a marked inflammatory response with a suggestive local production of cytokines. Notwithstanding, a few data are available on the circulating levels of cytokines and gastrin in the asymptomatic people carrying H. pylori infection. Thus, aim of the study was to evaluate circulating proinflammatory cytokines [Interleukin (IL)-8, Interleukin (IL)-10, Interferon (IFN)-gamma, and Tumor Necrosis Factor (TNF)-alpha] and gastrin levels in H. pylori positive asymptomatic subjects vs. H. pylori negative ones. To this end, thirty healthy volunteers with no digestive symptoms or systemic disease were enrolled and H. pylori infection was identified by a 13C-urea breath test. Plasma levels of gastrin were determined using the RIA kit whereas IL-8, TNF-alpha, IL-10, and IFN-gamma levels in serum were measured with a solid-phase ELISA. Fifteen infected people showed significantly higher gastrin and TNF-alpha levels than uninfected subjects. On the contrary, IL-8 levels were significantly higher in the uninfected subjects than in H. pylori positive ones (P < 0.0422). IFN-gamma and IL-10 circulating levels were not affected by H. pylori presence, being not significantly different in the two groups.     

Diagnosis of Helicobacter pylori infection in adults and children by using the Malakit Helicobacter pylori, a commercially available enzyme-linked immunosorbent assay.

Malakit Helicobacter pylori (Biolab, Limal, Belgium) is a second-generation enzyme-linked immunosorbent assay (ELISA) for the detection of Helicobacter pylori infection. We evaluated its ability to diagnose H. pylori infection in 489 asymptomatic pregnant women, 427 asymptomatic children, and 95 symptomatic children. 87 asymptomatic adults (17.8%), 31 asymptomatic children (7.3%), and 27 symptomatic children (28.4%) were seropositive. We observed an increase in H. pylori infection with age. 13C-urea breath tests were performed for all seropositive and 100 randomly selected seronegative asymptomatic adults. They were also performed for all seropositive and 65 randomly chosen seronegative asymptomatic children. Breath tests were positive for 86 of 87 (98.9%) seropositive adults, 30 of 31 seropositive children (96.8%), and no seronegative individual. Compared with those of culture, the sensitivity and specificity of the Malakit Helicobacter pylori were both 96%. We conclude that the Malakit Helicobacter pylori is equally suitable for adults and children. Therefore, this ELISA can be proposed as an important alternative to other more time-consuming and/or more expensive diagnostic tests for the detection of H. pylori.     

Effect of Helicobacter pylori infection on intragastric urea and ammonium concentrations in patients with chronic renal failure.

AIM--To assess the value of measuring the gastric juice urea:ammonium ratio in detecting Helicobacter pylori infection in patients with chronic renal failure. METHODS--Twenty three (12 men) patients with established chronic renal failure and dyspepsia were studied. Gastric juice (2 ml) was aspirated during endoscopy to measure urea and ammonium. The upper gastrointestinal tract was routinely inspected and two antral biopsy specimens obtained. The 14C-urea breath test was conducted within 14 days of endoscopic examination to determine H pylori antibody response. RESULTS--The median (range) serum urea concentration in 11 patients with renal failure and H pylori infection was similar to that in 12 without H pylori infection. The median gastric juice urea concentration in subjects with infection was lower than that in the subjects without infection (p < 0.01). The median gastric juice ammonium concentration in subjects with the infection was higher compared with subjects without infection (p < 0.01). There was an overlap of the urea and ammonium concentrations in gastric juice from both H pylori positive and negative subjects. The urea:ammonium ratio was 0.16 (0.01-1.11) for subjects with H pylori compared with 1.63 (1.0-18.9) in subjects without infection (p < 0.001). CONCLUSION--The urea:ammonium ratio differentiated both groups, with the exception of one false negative result. The urea:ammonium ratio proved almost as effective in identifying the presence of H pylori infection in subjects with chronic renal failure as it had in subjects with normal renal function.     

Serological differentiation of Helicobacter pylori CagA(+) and CagA(-) infections

Many Helicobacterpylori strains causing gastroduodenal diseases have a cagA gene encoding CagA protein, a virulence factor of these bacteria. Anti-CagA antibodies produced by the majority of people infected with CagA(+) strains can indicate such an infection. In this study, the efficacy of three immunoenzymatic tests for detecting CagA(+) and CagA(-) infections were compared: immunoblot (Milenia ID Blot H. pylori IgG; MB) and ELISA conducted either with a recombinant immunodominant fragment of CagA (rCagA) or the full-length CagA molecule (flCagA). The 13C-urea breath test (13C-UBT) was used for establishing H. pylori status. The serum samples from 157 individuals were used for serodiagnosis. H. pylori CagA(+) infection was detected in H. pylori-infected individuals with similar frequencies by MB (64%) and flCagA-ELISA (60%) and a little less frequently by rCagA-ELISA (53%). There was a high coincidence between the negative results of these three tests for H. pylori-uninfected individuals with no anti-CagA IgG in the serum (96-100%). The results show that rCagA-ELISA and, especially, flCagA-ELISA are easy, inexpensive and useful noninvasive assays for the discrimination of CagA(+) and CagA(-) H. pylori infections in subjects examined by urea breath test.     

Positive Result by Serology Indicates Active Helicobacter pylori Infection in Patients with Atrophic Gastritis

Patients with atrophic corpus gastritis and elevated Helicobacter pylori antibody titers but ¹³C-urea breath test (¹³C-UBT) and histology results negative for H. pylori were randomized into eradication therapy or follow-up only. Antibody levels decreased significantly in six out of seven patients in the eradication group, while in the follow-up group, the titers declined in only one out of eight patients. In patients with atrophic corpus gastritis, positive serology results may indicate an ongoing infection in spite of negative ¹³C-UBT and histology results.