胃内酸化消除胃内细菌过生长造成的^(14)C-尿素呼气试验假阳性  

INTRAGASTRIC ACIDIFICATION ELIMINATE THE FALSE POSITIVE RESULTS OF ^(14)C-UREA BREATH TEST CAUSED BY INTRAGASTRIC BACTERIUM OVER-GROWTH

作　　者：贺克俭 张厚德 曾忠铭 麦丽文 单明英 

机构地区：[1]深圳市南山医院消化科,广东深圳518052

出　　处：《中国微生态学杂志》2003年第2期94-95,共2页Chinese Journal of Microecology

摘　　要：目的 :观察胃内细菌过生长是否可以引起 1 4C-尿素呼气试验假阳性 ,同时胃内酸化是否能即刻消除这种影响。方法 :5 8名胃黏膜组织学 Hp阴性、常规 1 4C- UBT( U BT- 1)也阴性的溃疡样型功能性消化不良的病人口服雷贝拉唑 2 0 mg/ d、共 7d。于第 6天常规 1 4C- UBT( U BT- 2 )。U BT- 2阳性者于第 7天再进行一次改良的 1 4C- U BT( U BT- 3) ,方法是在服用 1 4C-尿素胶囊前 2 0 m in和服用胶囊时各加饮 15 0 m l0 .1mol/ L的柠檬酸水。比较三次 U BT的 1 4CO2 呼出率。结果 :雷贝拉唑明显增加 Hp阴性病人 1 4CO2 呼出率 ,U BT- 1为 ( 2 4 .0± 10 .8) dpm / mm ol CO2 ,U BT- 2为 ( 6 3.6± 16 .8) dpm / m mol CO2 ( ( t=2 .310 ,P<0 .0 5 )。U BT- 2有 9例假阳性 ( 9/ 5 8,16 % )。但胃内酸化后的 UBT- 3的 1 4CO2 呼出率又落至 ( 2 1.0± 7.8) dpm/mm ol CO2 ( ( t=2 .0 6 8,P<0 .0 5 ) ,9例假阳性者又恢复真阴性。结论 :胃内细菌过生长可以引起 1 4C-尿素呼气试验假阳性 。Objective:To observe whether gastric bacterium over growth will lead to the false positive results of 14 C UBT and intragastric acidification will eliminate this efect. Methods:Fifty eight functional dyspepsia patients(ulcer like type)with Hp negative results confirmed by both gastric histology and standard 14 C UBT(UBT 1) underwent a acid suppression treatment with Rabeprazole 20 mg/d for 7 day.On day 6,patients returned for a repeat standard 14 C UBT(UBT 2).On day 7,the patients underwent a modified 14 C UBT(UBT 3),which included consuming 150 ml of 0 1 mol/L citric acid solution 20 min before and at the administration of 14 C urea capsule Mean 14 CO 2 excretion were compared for the three UBTs.Results: Rabeprazole increased mean 14 CO 2 expiration from (24 0±10 8)dpm/mmol CO 2 in UBT 1 to (63 6±16 8) dpm/mmol CO 2 ( t=2 310,P <0 05) in UBT 2 with 9(9/58,16%) false positive results.After intragstric acidification 14 CO 2 expiration of UBT 3 fell back to (21 0±7 8) dpm/mmol CO 2 with no false positive results.Conclusion:Gastric bacterium over growth could lead to the false positive results of 14 C UBT and intragastric acidification would eliminate this effect.

关 键 词：胃内细菌过生长 尿素呼气试验 雷贝拉唑 非侵入性幽门螺杆菌诊断试验 假阳性 酸化剂 质子泵抑制剂 溃疡样型功能性消化不良 

分 类 号：R573.1[医药卫生—消化系统]