^(13)C-尿素呼气试验在不同年龄段儿童幽门螺杆菌感染中的诊断价值分析  

Diagnostic value of^(13)C-urea breath test in Helicobacter pylori infection in children of different ages

作　　者：高利伟[1] 吕金芳 郝彤彤 林健瑶 罗文雄[1] 颜斐斐[1] GAO Li-wei;LYU Jin-fang;HAO Tong-tong(Ddepartment of paediatrics,Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院,广东省儿童医院儿科消化科,511400

出　　处：《中国实用医药》2023年第14期87-89,共3页China Practical Medicine

基　　金：广东省中医药局科研项目资助(项目编号:20201034)。

摘　　要：目的探讨^(13)C-尿素呼气试验(^(13)C-UBT)在不同年龄段儿童幽门螺杆菌(Hp)感染中的诊断价值。方法228例疑似Hp感染患儿,将2~5岁患儿作为A组(62例),将6~17岁患儿作为B组(166例)。所有患儿均进行胃镜检查以及^(13)C-UBT、快速尿素酶试验(RUT)、Hp粪便抗原检测。记录所有患儿Hp感染情况;比较A组与B组患儿胃内胆汁反流发生情况,^(13)C-UBT假阴性与真阳性患儿胃内胆汁反流发生情况以及^(13)C-UBT检测Hp阳性的敏感度、特异度和准确度。结果联合检测Hp感染率86.4%(197/228)高于^(13)C-UBT检出阳性率65.4%(149/228),差异有统计学意义(P<0.05)。197例Hp感染患儿中胃内胆汁反流发生率为15.7%(31/197),其中B组胃内胆汁反流发生率为20.1%(28/139),高于A组的5.2%(3/58),差异具有统计学意义(P<0.05)。228例患儿中^(13)C-UBT检测Hp的敏感度为75.6%,特异度为96.8%,准确度为78.5%,阳性预测值为99.3%(149/150),阴性预测值为38.5%(30/78)。A组中^(13)C-UBT检测Hp的敏感度89.7%和准确度90.3%均明显高于B组的69.8%、74.1%,差异均具有统计学意义(P<0.05);两组的特异度比较,差异无统计学意义(P>0.05)。在^(13)C-UBT假阴性患儿中胆汁反流发生率35.4%(17/48)明显高于^(13)C-UBT真阳性患儿的9.4%(14/149),差异有统计学意义(P<0.05)。结论^(13)C-UBT在儿童Hp感染检测中的特异性和阳性预测值均较高,尤其在2~5岁儿童中具有相对较高的敏感度和准确度,对于^(13)C-UBT检测为阴性而临床疑似Hp感染的患儿,应联合其他检测方法进一步检查确诊,避免漏诊发生。Objective To discuss the diagnostic value of^(13)C-urea breath test(^(13)C-UBT)in Helicobacter pylori infection(Hp)in children of different ages.Methods Of the 228 children with suspected Hp infection,children aged 2-5 years were included as group A(62 cases)and children aged 6-17 years were included as group B(166 cases).All children underwent gastroscopy and^(13)C-UBT,rapid urease test(RUT),and Hp fecal antigen testing.Hp infection was recorded in all the children,and the occurrence of gastric bile reflux was compared between group A and group B.The occurrence of gastric bile reflux in children with false negative and true positive^(13)C-UBT was compared,as well as the sensitivity,specificity and accuracy of^(13)C-UBT in detecting Hp positivity.Results The rate of Hp infection was 86.4%(197/228)by combined testing,which was higher than that of 65.4%(149/228)by^(13)C-UBT,and the difference was statistically significant(P<0.05).The incidence of gastric bile reflux among 197 children with Hp infection was 15.7%(31/197),of which the incidence of gastric bile reflux in group B was 20.1%(28/139),which was higher than that of 5.2%(3/58)in group A,and the difference was statistically significant(P<0.05).The sensitivity of^(13)C-UBT for Hp detection in 228 children was 75.6%,specificity was 96.8%,accuracy was 78.5%,positive predictive value was 99.3%(149/150)and negative predictive value was 38.5%(30/78).The sensitivity of 89.7%and accuracy of 90.3%of Hp detection by^(13)C-UBT in group A were significantly higher than those of 69.8%and 74.1%in group B.The differences were statistically significant(P<0.05),while the differences were not statistically significant(P>0.05)when comparing the specificity of the two groups.The incidence of gastric bile reflux was 35.4%(17/48)in children with false-negative^(13)C-UBT,which was significantly higher than that of 9.4%(14/149)in children with true-positive^(13)C-UBT,and the differences were all statistically significant(P<0.05).Conclusion The specificity and positive predictive val

关 键 词：儿童 ^(13)C-尿素呼气试验 胃炎 幽门螺杆菌 诊断价值 

分 类 号：R725.7[医药卫生—儿科]