幽门螺杆菌检测方法的临床评价

目的:评价各种幽门螺杆菌(Hp)检测试验,检测Hp感染和监测Hp根除治疗的可靠性。方法:未接受过抗Hp治疗的患者分为两组,A组331例,无胃部手术史;B组65例,胃大部切除术后。两组患者因上消化道症状而接受胃镜检查,以胃黏膜活检标本快速尿素酶试验(RUT)和组织学检查(W S染色)联合检测Hp作为"金标准",对幽门螺杆菌粪便抗原(HpSA)试验的准确性进行评价,并与另一非侵入性的13C尿素呼气试验(13C-U BT)加以比较。结果:A组患者经"金标准"诊断Hp阳性175例,阴性156例。B组患者阳性30例,阴性35例。C组患者于停药后第28 d经13C-U BT诊断Hp阳性16例,阴性40例。HpSA于停药后第1天54例阴性,此后随时间推移,未成功根除病例陆续转为阳性。而成功根除病例仍大部分持续在阴性范围,仅少数病例出现假阳性。停药后第28 d的准确性最高(92.9%)。结论:HpSA试验是一种可靠的非侵入性检测方法,对于抗Hp治疗前、后患者Hp感染的诊断均有较高的准确性。对于胃大部切除术后的患者亦有较高的诊断价值。

Helicobacter pylori ferting various methods of evaluation

Objective: Evaluation of various Helicobacter pylori testing and moniforing Hp infection evadication fo the reliability.Methods:The H.pylori infected patients referred to our departmentwere included.They were divided into two group s.The 331 patients in group A had intact stomach,and 65 patientsin group B had history of subtotal gastrectomy.All patients underwent gastroscopywith biop sies for rap id ureasetest(RUT) and histology,which was viewed as"gold standard".H.pylori status was defined as positive ornegative with both RUT and histology p resenting concordant positive or negative results.The results of these reference tests were compared with those obtained by HpSA test and 13C-urea breath test(13C-UBT).Results:In group A,175 patientswere defined as H.py loripositive and 156 as negative by the"gold standard".Ingroup B,30 patientswere defined as H.py loripositive and 35 as negative by the"gold standard".In group C,16 patientswere defined as H.py loripositive and 40 as negative by 13C-UBT on day 28 after antimicrobial therapy.HpSA tests became negative immediately after the end of treatment in 54 patients.During the 42week followup period,HpSA gradually changed to positive in patientswithout successful eradication and remained negative in patientswith successful eradication except for several cases.The accuracy of the HpSA test was excellent on day 28 after treatment(92.9%).Conclusion:HpSA test is a reliable noninvasive method for the diagnosis of H.py lori infection before and after treatment.It is also accurate for the detection of H.py lori infection in the patients with subtotal gastrectomy.