13C- BUT与血清Hp抗体检测在上消化道病变诊断中的应用  

The Application of 13C-BUT and Serum Hp Antibody Detection in the Diagnosis of Upper Gastrointestinal Disease

作　　者：黄耀奎[1] 陈乐川 黄小萍 叶晓丹 王小忠[1] HUANG Yaokui;CHEN Lechuan;HUANG Xiaoping;YE Xiadan;WANG Xiaozhong(Shantou Central Hospital,Affiliated Shantou Hospital of Sun Yat-sen University,Shantou 515031,China)

机构地区：[1]汕头市中心医院(中山大学附属汕头医院),广东汕头515031

出　　处：《标记免疫分析与临床》2020年第7期1176-1181,共6页Labeled Immunoassays and Clinical Medicine

基　　金：2018年汕头市第六批医疗卫生科技计划(编号:汕府科[2019]11号-41)。

摘　　要：目的研究血清Hp抗体相对于13C-UBT的诊断效能,指导Hp非侵入诊断的合理选择;探讨13C-BUT DOB值的意义、Hp感染与上消化道病变的相关关系。方法收集在本院初诊同时行13C-UBT和血清Hp抗体检测患者共328例,以13C-BUT作为"金标准"采用ROC曲线判断Hp抗体水平合理的阳性临界值;在本院同时行13C-UBT和上消化道内镜检查患者658例,对DOB值与上消化道病变行多重线性回归分析,13C-UBT定性结果与上消化道病变行Logistic回归分析Hp感染内镜诊断的相关因素。结果 (1)13C-UBT的DOB值与血清Hp抗体水平存在线性关系,但拟合度不高(r=0.375,P<0.01)。(2)当血清Hp抗体参考值为0~18AU/mL时,约登指数最大,灵敏度为86.9%,特异性为74.7%,诊断效能与13C-BUT拟合度较佳(AUC=0.817),可以作为Hp诊断的有效补充。(3)13C-UBT的DOB值与上消化道各类病变均不存在直线相关关系(P=0.066~0.593)。(4)胃溃疡、十二指肠球部溃疡是Hp感染的相关因素,且随着病变程度加重,Hp感染风险逐步升高(GU:P=0.012、β=0.510、OR=1.665;DU:P<0.01、β=0.456、OR=1.578),该类患者应常规检测Hp。结论 (1)13C-UBT的DOB值与Hp抗体水平存在线性关系,Hp抗体检测效能参考范围为0~18AU/mL时与13C-UBT拟合度较佳,可根据不同情况合理选择。(1)DOB值高低与上消化道病变病变程度无相关性,建议13C-UBT和血清Hp抗体检测结果以定性判读,不推荐分档判读。(3)胃溃疡、十二指肠球部溃疡患者应常规检测Hp,有利于治疗方案的合理选择。Objective To study the diagnostic efficacy of serum Hp antibody relative to 13C-UBT, so to guide the reasonable choice of non-invasive diagnosis method of Hp, and further to explore the significance of 13C-BUT DOB value and the relationship between Hp infection and upper gastrointestinal diseases.Methods Atotal of 328 patients who were first diagnosed in our hospital were tested for 13C-UBT and serum Hp antibody at the same time. 13C-BUT was used as the "gold standard" and ROC curve was used to judge the positive critical value of reasonable Hp antibody concentration. 13C-UBT and upper gastrointestinal endoscopy were performed in 658 patients at the same time. Multiple linear regression analysis was performed between DOB and upper gastrointestinal diseases. 13C-UBT qualitative results and logistic regression were used to analyze the related factors of endoscopic diagnosis of Hp infection.Results(1)There was a linear relationship between the DOB value of 13C-UBT and the concentration of serum Hp antibody, but the degree of fit was not high(P<0.01).(2)When the reference value of serum Hp antibody was within 0-18 AU/mL, the Yoden index was the largest, with the sensitivity 86.9%, the specificity 74.7%, and the diagnostic efficacy was in a good agreement with 13C-BUT(AUC=0.817), which could be used as an effective supplement to the diagnosis of Hp.(3)There was no linear correlation between the DOB value of 13C-UBT and all kinds of lesions of upper digestive tract(P=0.066 to 0.593).(4) Gastric ulcer and duodenal ulcer were the related factors of Hp infection, and the risk of Hp infection increased gradually with the aggravation of the disease(GU: P=0.012, β=0.510, OR=1.665;DU: P<0.01,β=0.456, OR=1.578), suggesting that Hp should be detected routinely in this kind of patients.Conclusion(1)There is a linear relationship between the DOB value of 13C-UBT and the concentration of Hp antibody. When the reference range of detection efficiency of Hp antibody is within 0-18 AU/mL, it is better to fit with 13C-UBT, which can

关 键 词：13C呼气试验(13C-UBT) 血清Hp抗体 上消化道病变 DOB值意义 相关性 

分 类 号：R372[医药卫生—病原生物学]