酶联免疫法检测粪便幽门螺杆菌(Hp)抗原与^(14)C-呼气试验在治疗Hp前后的对比研究  

Evaluation and Comparison of the Helicobacter Pylori Stool Antigen (HpSA) and 14C-urease Breath Test in Primay and Post-treatment.

作　　者：冯喜华[1] 朱尤庆[1] 周燕[1] 肖建群[1] 

机构地区：[1]武汉大学中南医院消化内科,武汉430071

出　　处：《临床消化病杂志》2004年第3期108-109,共2页Chinese Journal of Clinical Gastroenterology

摘　　要：目的:评价粪便幽门螺杆菌抗原(HpSA)检测方法的可靠性、准确性及对治疗后监测的意义。方法:用酶联免疫技术对72例接受内镜检查成年患者(除外孕妇)的粪便标本进行HpsA检测,以快速尿素酶试验、14C-呼气试验联合检测作为诊断标准,两项均阳性为Hp阳性,两项均阴性为Hp阴性。Hp阳性病例予以PPI加两种抗生素治疗2周,继续PPI治疗2周,停药4周后再行上述检测。结果:治疗前Hp阳性42例,阴性30例。HpSA检测Hp阳性43例,阴性29例。敏感度90.48％,特异度86.20％,阳性预测值88.37％,阴性预测值86.21％,准确度87.50％。治疗后HpsA检测与14C-呼气试验检测的敏感度、特异度、阳性预测值、阴性预测值分别为66.67％、100.00％;100.00％、95.45％;100.00％、75.00％;95.65％、100.00％。结论:HpSA检测方法是一种简便、易行、准确性高的非侵入性诊断方法,可用于治疗后的Hp监测。Objective:To evaluate the helicobacter pylori(Hp) stool antigen (HpSA) test in the assessment of Hp infection and its usefulness in determining Hp status after treatment. Methods: Seventy-two adult patients, except pregnant women were enrolled in the study. HpSA test, rapid urease test and 14 C-urea breath test (14C-UBT) were performed on all patients,the cases were defined as Hp positive if I4C-UBT and rapid urease test were positive,negtive if both were negtive.The positive parts of 42 adult patients were given omeprazole (20 mg bid), amoxycillin (1000 mg bid) and tinidazole (500 mg bid) for two weeks and omeprazole (200 mg qd) for other two weeks. After four weeks,all of the above tests were performed again. Results:72 patients were included in this study (47 men,25 women;mean age47.6 + /-13 years). Among all the cases,42 patients were diagnosed as Hp positive,30 patients were negtive.The HpSA test was positive in 43 cases and negtive in 29 cases.The sensitivity (SN) and the specificity (SP) were 90.48% and 86.20% , the positive predictive value(PPV) and the negtive predictive value(NPV) were 88.37% and 86.21 %, accurary was 87.50% . 42 adult patients were performed 14C-UBT.The SN, SP, PPV, NPV of the HpSA test and 14C-UBT post-treatment were 66. 67% , 100.00%; 100.00% , 95.45% ; 100.00% , 75.00% ;95.65%, 100.00%.There are no statistically different between them (X2 =0.25. P > 0.05) .Conclusion: The HpSA test is a simple, rapid, non-invasive methed for diagnosis Hp infection, and can be used in monitoring the effeciveness of treatment.

关 键 词：酶免疫技术 幽门螺杆菌 ^14C-呼气试验 

分 类 号：R446.6[医药卫生—诊断学]