血清学与呼气试验结合监测治疗幽门螺杆菌感染的疗效

APPLICATION OF SEROLOGY AND (14)￣C-UREA BREATH TEST TO MONITORING OF THE EFFECT OF ANTI-HELICOBACTER PYLORI CHEMOTHERAPY

为评价血清学及（１４）￣Ｃ－尿素呼气试验在治疗幽门螺杆菌（Ｈｐ）感染疗效监测价值，本研究中第一阶段对４２例Ｈｐ感染，患者在抗Ｈｐ治疗前、停药１、３、６、１２个月同期进行胃镜检查、（１４）￣Ｃ－尿素呼气试验及血清ＨｐＩｇＧ抗体测定。分析患者停药１年内随访期呼气试验及血清学变化规律，制定出以呼气试验高于界限值、血清学吸光度（Ａ）值比治疗前下降＜１５％为判断Ｈｐ阳转的疗效监测标准。第二阶段在另一批共６３例疗效监测患者中验证该标准，结果在停药６、１２个月呼气试验敏感性均为１００．０％，特异性分别为９５．５％及１００．０％；血清学敏感性均为１００．０％，特异性分别为５０．０％及８３．３％。结合两种方法的优缺点，提出在不同时期采用（１４）￣Ｃ－尿素呼气试验或血清学检测对治疗Ｈｐ感染进行疗效监测的联合方案。

n order to evaluate the value of serology and (14)￣C-urea breath test in moni toring the effect of anti-Helicobacter pylori chemotherapy, at the first stage of thls study,endoscopy,(14)￣C-urea breath test andserology(H. pylori IgG antibody rneasured by ELISA)were performed in 42 of patients before the onset ofanti-H, pylori chemotherapy dnd at 1.3,6 and 12 months after termindtion of the treatment.n analyz-ing the change of the results of hreath text and serology during the one year follow-up perlod in these pa-tients,“above the cutoff value”in breath test and “redtiction of A value less than 15% when comparingwith pretreatment”in serology were made as the H.pylori positive criteria for monitoring therapeutic ef-fectiveness on H. pylori.At the second stage of this study,total of another 63 of patients were studied totest the accuracy of the monitoring criteria,The results showed that the sensitivity of breath test was all100.0% and specificity 95.5% and 100.0% respectively at 6 and 1 2 month after termination of treat-ment, the sensitivity of serology was all 1 00.0% and specificity was 50.0%and 83.3%respectively.Ascheme for monitoring the effect of anti-H. pylori chemotherapy by combinatition of (14)￣C-urea breath testand serology is proposed based on this study.