1225例次^(14)碳-尿素呼气试验结果分析  

Analysis on the results of 1225 14C- urea breath tests

作　　者：王承党[1] 庄则豪[1] 陆岽[1] 李文清[1] 陈玉丽[1] 

机构地区：[1]福建医科大学附属第一医院消化科,福州市350005

出　　处：《中国全科医学》2003年第9期723-725,共3页Chinese General Practice

基　　金：福建省三项费资助(K98033)

摘　　要：目的 分析1225次幽门螺杆菌(Hp)^(14)C-尿素呼气试验(^(14)C-UBT)结果,并探讨门诊根除Hp的治疗情况。方法 接受^(14)C-UBT检测的患者共983例,其中慢性胃炎(CG)676例、十二指肠溃疡(DU)189例、胃溃疡(GU)34例、非胃肠道疾病84例。其中242例治疗后复查,总检测次数1225次。记录门诊治疗Hp的用药情况。结果 983例被检者中^(14)C-UBT阳性率为61.44％,其中胃病组为63.85％,非胃病组为35.71％,两组间差别有显著性意义(P<0.001)。40例吹气标本分别于当天、24小时和第3天各测定1次,3次判定结果的一致率为100％。铋剂三联(82.6％)、含克拉霉素PPI三联(86.0％)、含阿莫西林PPI三联(84.1％)、H_2RA三联(75.6％)4个治疗组^(14)C-UBT阴转率间差别无显著性意义(P>0.05);两联治疗(16.0％)、单一药物治疗(4.8％)及“药物不详”组(40.9％)的阴转率与4个三联治疗组的阴转率间差别有显著性意义(P<0.001)。二联治疗和单一药物治疗病例占复查总数的19.01％(46/242)。结论 门诊慢性胃病患者Hp感染率高于非胃病患者,约有20％～25％的患者接受不规范的“根除”治疗,^(14)C-UBT是一种检测幽门螺杆菌现症感染简单、有效的手段,适合于基层应用。Objective To analyze the results of 1225 14C - urea breath test ( UBT) and to evaluate the efficacy of e-radication therapy of helicobacter pylori in outpatients. Methods 't - UBT for helicobacter pylori were performed in 983 gastrointestinal outpatients, including 676 cases with chronic gastritis, 189 duodenal ulcer, 34 gastric ulcer, and 84 with non -gastrointestinal disorders. The tests were repeated after eradication therapy in 242 patients, and the prescriptions were also analy-sised. Results The positive rate was 61. 44% in 983 cases according the setting criterion, and was significantly higher in gastroduodenal diseases than in non - gastrointestinal disorders (63. 85% vs 35. 71 % , P < 0. 001 ) . It was highest in patients with duodenal ulcer (85. 19% ). Forty breath samples were tested at three different time points (the sample - collecting day, 24 hours and 3 days after ingesting the 14C - urea capsule) , and the results were coincident with the setting criterion. After eradication therapy the UBT negative rate was 82. 61% in group with bismuth subcitrate- based triple therapy, 86. 05% in PPI - based triple therapy including clathromycin, 84. 09% in PPI - based triple therapy including amoxicillin, and 75. 61 % in H2 - antagonist-based triple therapy ( P >0. 05). Of 242 patients, 19.01% were treated with bitherapy or single -drug. The negative rate was significantly lower in the patients with bitherapy (16. 00% ) , or single -drug (4. 76% ) , and unknown -drug (40. 91 % ) than in triple therapy groups ( P <0. 001 , respectively). Conclusion The prevalent rate of helicobacter pylori was significantly higher in patients with chronic gastroduodenal diseases than in non -gastroduodenal patients, However, about 1/4 ~ 1/5 outpatients with helicobater pylori were accepted an irregular therapy in some hospitals, 14C - UBT is an efficacious, simple method for diagnosis of helicobacter pylori infection in outpatients.

关 键 词：幽门螺杆菌 ^14C-尿素呼气试验 消化性溃疡 慢性胃炎 

分 类 号：R573[医药卫生—消化系统]