儿童幽门螺杆菌感染临床检测方法评价

目的探讨适合检测儿童幽门螺杆菌(Hp)抗原的方法。方法对2000年9月-2006年2月儿科消化专科门诊及住院937例患儿行13C尿-素呼气试验(13C-UBT)。其中96例行胃黏膜活检标本检测;557例行Hp粪便抗原(HpSA)检查。2003年4月-2004年4月105例患儿同时进行13C-UBT及HpSA检测,以13C-UBT作为诊断标准。结果1.13C-UBT阳性检出率为41.7%,胃镜取胃黏膜活检的Hp抗原阳性检出率40.6%,HpSA的抗原阳性检出率为38.2%,三者间无统计学差异。2.同时行13C-UBT及HpSA患儿105例,13C-UBT阳性率为41.9%,HpSA阳性率为39.0%,以13C-UBT为诊断标准,HpSA检测Hp感染敏感性为91.8%、特异性为81.8%、一致性Kappa系数为0.743(P=0),13C-UBT与HpSA检测阳性检出率无统计学差异(P=0.388)。结论13C-UBT与HpSA 2种检测方法均可作为临床非侵入性检测Hp抗原有效方法,且HpSA更简便、非侵入、经济,是儿童及家长更易接受的诊断儿童Hp感染的有效方法。

Evaluation of Clinical Detection Methods for Detection of Helicobacter Pylori Infection in Children

Objective To explore the optimal methods to detect helicobacter pylori(Hp)antigen in children.Methods 13C labeled urea breath test(13C-UBT)was performed on 937 children of alimentary department from Sep.2000 to Feb.2006.Gastric mucosa biopsy of 96 children was detected.Hp stool antigen(HpSA)status of the 557 children were evaluated.Both 13C-UBT and HpSA were assayed in 105 children from Apr.2003 to Apr.2004.Method of 13C-UBT was taken as the golden standard on diagnosis of Hp infection.Results Forty-one point seven percent children was positive for 13C-UBT.Forty point six percent children was positive for gastric mucosa biopsy.Thirty-eight point two percent was positive for HpSA.The difference was not significant.2.Among the 105 children performed by both 13C-UBT and HpSA,41.9% was positive for 13C-UBT and 39.0% for HpSA.Taking 13C-UBT as the golden standard,sensitivity of HpSA to diagnose Hp infection was 91.8%,and its specificity was 81.8%.Consistency Kappa coefficient was 0.743(P=0),which denoted that there was no significant difference on the positive detection rate between 13C-UBT and HpSA(P=0.388).Conclusions 13C-UBT and HpSA as non-invasive technique is effective to detect the Hp antigen.Compared to 13C-UBT,as a convenient,noninvasive,economical method,HpSA detection is much more acceptable to children and their patients.