幽门螺杆菌感染三种诊断方法的分析评价

目的：对幽门螺杆菌（Ｈp)的三种临床诊断方法－病理组织学，血清学，快速尿素酶试验的敏感性，特异性，有效性，阳性预测值及阴性预测值进行分析评介，方法，对１８６例因上腹不适的病人进行胃镜检查并取胃粘膜组织作快速尿素酶试验及病理组织学检查Ｈp，同时抽血做血清抗幽门螺杆菌抗体测定，其中二项阳性认为有Ｈp 感染，结果：病理组织学，血清学，快速尿素酶试验的敏感性分别为８１．８%,93.5%,84.5%，特异性分别为96.7%,83.7%,81.4%,有效性分别为８５．５％，９０．９％，84.9%，阳性预测值分别为９8.2%,94.1%,92.9%，阴性预测值分别为６５.3%,82.0%,67.8%,结论，三种方法均有较高的敏感性，特异性及有效性，尤以病理组织学特异性最高，对于Ｈp的诊断参考，在一般临床工作中可任选其中一种。

Evaluation of three methods for detection of Helicobacter pylori infection

Objective:To evaluate three methods for detectation of helicobacter pylori(HP)infection,including histology,serology,and rapid urease test(RUT),of their sensitvities specificities,validities,the positive prediction values and negative prediction values Methods:186 consective patients with symptoms of epigastric pain and dyspepsia underwent endoscopy and piopsy of gastric antrum The biopsied speciments were stained with Giemsa haematoxylin and eosin(HE),and tested by rapid urease test Serology was performed at the same time,using a rapid visual test for the qualitative detection of antibodies to Hp The standard for diagnoing Hp infection is the presence of two positives among three dectective methods Results:The sensitivity of histology,serology and RUT was 81 1%,93 5%,86 6%,respectively,the specificity was 96 7%,83 7%,81 4%,respectively,the validity was 85 5%,90 9%,84 9%,respectively,the positive prediction value was 98 2%,94 1%,92 9%,respectively,and negative prediction value was 65 3%,82 0%,67 8% respectively Conclusions:There are a high sensitivity,specificity and better validity in all of three methods for detectation of Hp infection There seems to be more sensitive in histology one,and any one of the three methods can be use for diagnoing Hp infection in routine clinical work