短期用药对幽门螺杆菌检测结果的影响

目的：研究短期不规则用药对幽门螺杆菌(Hp)检测结果的影响。方法：136名慢性胃炎及消化性溃疡的住院患，根据病史分为服药组即Hp检查前一周内接受过铅剂、抑酸剂治疗的患，共四例。对照组即Hp检查前未接受过药物治疗的患考，共37例。Hp检查方法包括①血清学方法；②快速尿素酶试验(RUT)；③组织学方法；④13c—尿素呼气试验(13C—UBT)。结果：服药组RUT，组织学，13C—UBT方法Hp检出率分别为9．0％，21．2％，27．3％，均显低于对照组相应Hp检出率37．8％、40．5％、48．6％(P＜0．01，P＜0．05，P＜0．05)。两组血清学方法Hp IgG、IgM阳性率各为48．5％，51．5％和54．1％，54．1％(P＞0．05)。单独服用质子泵抑制剂组RUT，组织学方法Hp检出率4．0％，16．0％显低于对照组相应方法Hp检出率(P＜0．01，P＜0．05)。单独服用枸橼酸铋钾、H2受体拮抗剂患中各方法Hp检出率与对照组检出率无显性差异(P＞0．05)。单独服用枸橼酸铋钾、H2受体拮抗剂、质子泵抑制剂三组Hp感染率14．3％、15．0％、16．0％均显低于对照组Hp感染率46．0％(P＜0．05)。结论：Hp检查前短期使用铋剂、抑酸剂可导致Hp检出率下降，短期使用质子泵抑制剂可显降低RUT、组织学方法Hp检出率；各方法中快速尿素酶试验检出率最低。血清学方法检测Hp抗体不受药物影响。

The Effect of Short- term Usage of Drugs on the Detection of Helicobacter Pylori

Objective: To study the effect of short - term usage of drugs on the detection of Helicobacter pylori(Hp) . Methods: Total 136 inpatients were divided into two groups,one group included 99 patients who accepted therapy with colloidal bismuth or(and) histamine - 2 receptor antagonists(H2RAs) or(and) proton pump inhibitor(PPI) within seven days before the detection of Hp.one group(control group) included 37 patients who did not accepted drug therapy before Hp detecting .The methods of detecting Hp included rapid urea enzyme test(RUT), 13C - urea breath test(13C - UBT) , tissue staining and serum detecting of Hp IgG, IgM with ELISA. Results: The positive rate of Hp detected by technique of RUT, tissue staining, 13C - UBT in the therapy group were 9.0%, 21.2% and 27. 3% respectively, which were lower significantly than the rates of the control group( 37.8%, 40.5%, 48.6% ), (P<0.01,P<0.05,P<0.05). There were no significantly difference between the positive rate of Hp IgG, IgM in the two groups(48.5%,51.5% vs 54. 1% ,54. 1%) (P > 0.05) .The positive rate of Hp detected by RUT and tissue staining in patients treated only by PPI were 4.0% and 16.0% respectively, which were lower significantly than the rate of control group (P < 0.01, P< 0.05) . There were no significantly difference between the detected positive rate with RUT or tissue staining or 13C - UBT in patients treated by colloidal bismuth or H2RAs and the rates of control group (P > 0.05) .The positive rate of Hp infection in patients treated by colloidal bismuth, H2 receptor antagonist or PPI were 14. 3% , 15.0% and 16.0% respectively and were significantly lower than the rate of control (46.0% ,P < 0.05). Conclusion: Short - term therapy with colloidal bismuth, H2 RAs or PPI can decrease the detected rate of Hp infection ;PPI can decrease the Hp detected positive rate by RUT or tissue staining; the positive rate of Hp detected by UBT is the lowest.Serum Hp IgG,IgM can not be effected by short - term usage of the drugs.