粪便幽门螺杆菌抗原半定量检测  

Semi-quantitative detection of Helicobacter pylori antigen in feces

作　　者：杜金龙 罗瑜 谭延国[1] 张岩[1] 胡景[3] 刘淑梅[1] 杜海燕[1] 唐春燕 董一红 田野[1] 李卓敏 翟翠静[4] 陈伟东[4] 边洪禹 王英[5] 丁瑞恒[5] DU Jinlong;LUO Yu;TAN Yanguo;ZHANG Yan;HU Jing;LIU Shumei;DU Haiyan;TANG Chunyan;DONG Yihong;TIAN Ye;LI Zhuomin;ZHAI Cuijing;CHEN Weidong;BIAN Hongyu;WANG Ying;DING Ruiheng(Department of Clinical Laboratory,Fuxing Hospital,Capital Medical University,Beijing 100038,China;Department of Clinical Laboratory Diagnosis,Capital Medical University,Beijing 100038,China;Department of Gastroenterology,Fuxing Hospital,Capital Medical University,Beijing 100038,China;Department of Pathology,Fuxing Hospital,Capital Medical University,Beijing 100038,China;Department of Nephrology,Fuxing Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属复兴医院检验科,北京100038 [2]首都医科大学临床检验诊断学系,北京100038 [3]首都医科大学附属复兴医院消化内科,北京100038 [4]首都医科大学附属复兴医院病理科,北京100038 [5]首都医科大学附属复兴医院肾内科,北京100038

出　　处：《国际检验医学杂志》2021年第19期2305-2308,共4页International Journal of Laboratory Medicine

基　　金：北京市临床重点专科医学检验科培育项目(京卫医〔2020〕129号)。

摘　　要：目的建立幽门螺杆菌抗原(Hp-Ag)检测的半定量方法,探索Hp-Ag半定量检测结果与胃部幽门螺杆菌(Hp)感染菌量的关系,并就其诊断效能与其他Hp的检测方法进行比较评价。方法使用胶体金免疫层析分析仪测定Hp阳性者条带的灰度值作为半定量的依据;纳入363例消化内科患者和体检健康者,探讨测定其粪便Hp-Ag半定量检测、胃组织切片染色镜检法、13C呼气试验、血清Hp抗体(Hp-Ab)检测对Hp的检测效能、Hp-Ag半定量检测灰度值与胃组织菌量的关系,以及Hp在各年龄段健康体检人群中的检出情况等。结果粪便Hp-Ag半定量检测与胃组织切片染色镜检法对Hp的检出率比较,差异无统计学意义(P>0.05)。Hp-Ag半定量检测灰度值与胃组织切片染色镜检法Hp菌量具有相关性(r=0.898,P<0.05);Hp-Ag半定量检测对Hp的检出率明显高于13C呼气试验(53.97%vs.34.92%,P<0.05)。Hp-Ag半定量检测与Hp-Ab检测对Hp的检出率相当,且二者互补性极强,联合检测可将检出率从48.38%、50.18%提升至63.53%。>40~60岁人群中Hp检出率最高,达到54.55%。结论粪便Hp-Ag半定量检测,由于其简便、快捷、通量大,可较好地反映Hp的菌量,其性能不逊于其他“金标准”方法,值得应用推广。Objective To establish a semi-quantitative detection method for Helicobacter pylori antigen(Hp-Ag),and to explore the relationship between the semi-quantitative results of Hp-Ag and the amount of Hp,and to compare its efficacy with other detection methods for Hp.Methods The gray value of Hp positive bands was measured by colloidal gold immunochromatographic analyzer as a semi quantitative basis.A total of 363 patients in Department of Gastroenterology and healthy persons were included.Hp was detected by semi quantitative detection of fecal Hp-Ag,staining microscopy of gastric tissue sections,13C breath test and serum Hp antibody(Hp-Ab).The detection efficiency of various methods for Hp,the relationship between the gray value of Hp-Ag semi quantitative detection and the amount of bacteria in gastric tissue,and the detection of Hp in healthy people of all ages were discussed.Results There was no significant difference in the detection rate of Hp between fecal Hp-Ag semi quantitative detection and staining microscopy of gastric tissue sections(P>0.05).The gray value of Hp-Ag semi quantitative detection was correlated with the amount of Hp bacteria in staining microscopy of gastric tissue sections(r=0.898,P<0.05).The detection rate of Hp in Hp-Ag semi quantitative test was significantly higher than that in 13C breath test(53.97%vs.34.92%,P<0.05).Although the detection rates of Hp-Ag and Hp-Ab were similar,they were highly complementary,and their combined detection could increase the positive rate of healthy physical examination from 48.38%and 50.18%to 63.53%.The detection rate of Hp in people aged>40-60 was the highest,reaching 54.55%.Conclusion The semi-quantitative determination of Hp-Ag in feces,is simple,efficient,and could be applied to large cohort.It can not only precisely reflect the amount of bacteria,but also has good performance,compared to other gold standard methods.It is worthy of clinical use.

关 键 词：幽门螺杆菌 粪便幽门螺杆菌抗原半定量检测 活动性胃炎 

分 类 号：R446.5[医药卫生—诊断学]