常规胃内酸化可提高^(14)C-UBT诊断的准确性  

Intragastric acidification increases the accuracy of ^(14)C-urea breath test

作　　者：宋薇[1] 张厚德[1] 

机构地区：[1]广东医学院附属南山医院消化科,广东深圳518052

出　　处：《中国微生态学杂志》2007年第5期446-447,共2页Chinese Journal of Microecology

摘　　要：目的观察在进行14C-尿素呼气试验(UBT)时常规进行胃内酸化是否可提高14C-UBT试验诊断的准确性。方法250例因消化不良需要进行胃镜检查的门诊患者分为传统14C-UBT组和酸化14C-UBT组。传统14C-UBT组按常规方法进行试验,酸化14C-UBT组的检测过程与传统14C-UBT基本相同,唯一的差别是以0.1 mol/L的柠檬酸水200 m l(加少量甜味剂)送服14C尿素胶囊。比较2次UBT的14CO2呼出量、诊断的敏感性、特异性及准确性。结果(1)2组幽门螺杆菌(H.pylori)阳性的患者平均14CO2呼出量酸化组高于传统组,而2组H.pylori阴性的患者平均14CO2呼出量酸化组低于传统组,且统计学上差异均有显著性(P<0.05)。(2)传统14C-UBT组诊断的准确性、特异性、敏感性分别为92%、91%、92%;而酸化14C-UBT组分别为98.5%、100%、98%。2组间的诊断准确性及特异性差异有显著性(P<0.05);敏感性差异无显著性(P>0.05)。结论在14C-尿素呼气试验时常规进行胃内酸化可提高诊断的准确性。Objective To investigate whether intragastric acidification could improve the accuracy of ^14C-urea breath test. Methods Two hundred and fifty functional dyspepsia patients were divided into two groups to undergo a test. The first group of one hundred and twenty-five patients underwent conventional ^14C-urea breath test （UBT-1） ,while the second group of the same amount of patients took a modified UBT（ UBT-2）, which was similar with UBT-1 but includs consuming 200 ml of 0.1 .mol/L citric acid solution at the administration of ^14C-urea. Mean ^14CO2 expiration and the accuracy, specificity and sensitivity of the diagnosis were compared for the two UBTs. Results （ 1 ） To the patients with H. pylori positive results,the Z4CO2 expiration in UBT-1 was more than that in UBT-2 （P 〈0.05） ; patients with H. pylori negative resuits, ^14CO2 expiration in UBT-1 was less than that in UBT-2 （ P 〈 0.05 ）. （2） The first group ： the accuracy, specificity and sensitivity of diagnosis were 92% ,91% and 92% correspondingly. On the other hand, the accuracy ,specificity and sensitivity were 98.5% ,100% and 98% respectively,which were higher than that of the first group,but there was no evident difference on the sensitivity between two groups. Conclusion Giving citric acid at the administration of ^14C-urea breath test can increase the accuracy of the diagnosis.

关 键 词：幽门螺杆菌 尿素呼气试验 

分 类 号：R443.6[医药卫生—诊断学]