幽门螺杆菌粪便抗原检测在幽门螺杆菌感染的应用

Clinical Application for Detection of Helicobacter Pylori Infection in Children with Helicobacter Pylori Stool Antigen Test

目的 评估幽门螺杆菌粪便抗原 (HpSA)试验在幽门螺杆菌 (Hp)感染治疗前后的准确性。方法 收集 62例 4～ 1 7岁因上消化道症状就诊而接受1 3C 尿素呼气试验 (1 3C UBT)、胃镜检查和 31例根除Hp后停药至少 4周 ,接受1 3C 尿素呼气试验 2d内患儿粪便标本 ,应用酶免疫反应原理进行HpSA试验 ;以1 3C UBT检测和胃镜活检作为诊断标准。结果 以光密度值 (A)≥0 .1 2 1为阳性 ,HpSA检测治疗前诊断Hp感染敏感性为 92 .30 %、特异性 91 .30 %、阳性预测值为 92 .30 %、阴性预测值 87.50 %、准确性 91 .94% ;治疗后诊断Hp感染敏感性为 83 .33 %、特异性 88.0 0 %、阳性预测值为 62 .50 %、阴性预测值 95 .65 %、准确性 87.1 0 %。结论 HpSA检查对治疗前诊断儿童Hp感染准确率较高 ;对治疗后的诊断敏感性和特异性较治疗前低。

Objective To evaluate the accuracy of the Helicobacter pylori stool antigen (HpSA) test for detection of Helicobacter pylori (Hp) infection before and after treatment in children.Methods stool specimens were collected from 62 consecutive patients (4-17 years) who received 13 C-urea breath test( 13C-UBT) and/or gastroscopy for gastrointestinal symptom and 31 patients after radical cure of Hp who received 13 C-UBT within 2 days.The evaluation of Hp status was defined as positive when 13 C-UBT were positive and gastroscopic biopsy were positive.Results The sensitivity of HpSA test for the diagnosis of Hp using a cutoff value of 0.121 was 92.30% and its specificity and accuracy was 91.30% and 91.94%,respectively.sensitivity was 83.33% and its specificity was 88.00% and accuracy was 87.10% after radical cure of Hp.Conclusions The precision ratio of HpSA test is higher to diagnose Hp infection before the radical cure in children.Sensitivity and specificity after the radical cure are lower than before.