五种检测幽门螺杆菌感染方法的评估

Evaluation of 5 Detection Methods for Hp Infection

目的对五种检测幽门螺杆菌(Hp)感染的方法进行评估。方法对193例有胃肠道症状患者进行快速尿素酶试验(RUT)、组织学检(Warthin-Starry)、13C-尿素呼气试验(13C-UBT)、幽门螺杆菌粪便抗原 (HpSA)、幽门螺杆菌聚合酶链反应(Hp-PCR)五项试验,以上述五项中二项阳性为Hp阳性,全部五项阴性为 Hp阴性作为“金标准”。结果 193例患者按“金标准”诊断Hp阳性94例,阴性99例,RUT、组织学检查(W-S 银染)、13C-UBT、HpSA、Hp-PCR敏感度分别为:78．9％、72．9％、93．6％、89．6％、76．0％,特异度:78．6％、97．9％、 91．9％、90．7％、97．9％,准确度:78．8％、85．5％、92．9％、90．2％、86．5％,阳性预测值:78．1％、97．2％、91．7％、90．5％、 97．4％,阴性预测值:79．4％、78．5％、93．8％、89．8％、99．1％。结论 13C-UBT、HpSA试验是诊断Hp感染及追踪 Hp根治的简便、准确和非侵入性的检查方法。

Objective To evaluate 5 detection methods for Hp infection. Methods 193 patients with upper digestive tract symptoms were diagnosed by 5 tests： RUT, Warthin-Starry test, ^13C-UBT, HpSA, and Hp-PCR. It＇s the golden standard that 2 or more than 2 of the 5 tests positive mean Hp infection and all 5 tests negative mean without Hp infection. Results According to the gold standard,94 cases of all 193 patients were diagnosed Hp infection positive and other 99 were negative.Sensi tivities of all 5 tests： RUT, Warthin-Starry test, 13C-UBT, HpSA, and Hp-PCR, are 78.9%, 72.9%,93.6%, 89.6% and 76.0%, respectively; specificities are 78.6%, 97.9% ,91.9% ,90.7 % and 97.9%, respectively; accuracies are 78.8% ,85.5% ,92.9% ,90.2% and 86.5% respectively;positive predictive values are 78.1% ,97.2%, 91.7% ,90.5% and 97.4%,respectively;negative predictive values are 79.4%,78.5%,93.8% ,89.8% and 99.1%, respectively. Conclusion ^13C-UBT, and HpSA are the two simple, accurate and noninvasive detection methods for diagnosis and following up of Hp infection.