儿童再发性腹痛中幽门螺杆菌不同检测方法

Application of different methods for detecting Helicobacter pylori in the diagnosis of children's recurrent abdominal pain

目的评价幽门螺杆菌(H.pylori)的不同检测方法及H.pylori感染在儿童再发性腹痛(RAP)诊断中的应用。方法对在我院诊治的儿童RAP 72例,分为学龄期组24例,少年组48例,同时进行细菌培养、快速尿素酶试验、病理组织学检查、血清学H.pylori抗体检测和粪便H.pylori抗原(HpSA)检测。将前3项检查中2项阳性或细菌培养一项阳性作为诊断H.pylori感染的金标准。结果金标准诊断H.pylori感染,阳性占37例,阴性占35例,总阳性率为51.4%;学龄期儿童组H.pylori检出阳性率为37.5%,少年组H.pylori检出阳性率为58.3%,两组比较差异有显著性(P<0.01);比较6种不同检测方法的敏感性、特异性、准确性,经χ2检验,差异均无显著性(P>0.10)。结论H.pylori感染与儿童RAP之间存在一定的联系,少年组H.pylori感染率高于学龄期儿童组,而粪便HpSA检测有较高的敏感性和特异性,是一种简便可靠,非侵入性的诊断H.pylori感染的方法,尤其适合儿童。

Objective To Evaluate the different methods for detecting Helicobacter pylori （H. pylori） and study the application of H. pylori infection in the diagnosis of children＇s recurrent abdominal pain（RAP）. Methods Collected 72 samples with RAP from our hospital,and divide them into school-age group （24 samples） and teenager group （ 48 samples）and analyze them with the culture of bacteria, rapid urease test, pathological test, Seral H, pylori antibody test and fecal H. pylori antigen test（ HPSA） simultaneously. Those with positive 2 of the former 3 tests or positive culture are infected by H. pylori ,which was regarded as a golden criterion. Results 37 and 35 children were H. pylori positive and negative respeetively, using the golden criterion, with a positive rate of 5,1.4%. pH positive rate were 37.5 % and 58.3%in school-age group and teenager group respectively, with significant difference （P〈0. 01）. No significant difference（P〉0.10）were found for sensitivity, specificity and accuracy between either 2 of the 6 methods, using Z2 test. Conclusions There is certain relation between the infection of H. pylori and children＇s RAP. H. pylori positive rate of school-age group is higher than that of teenager group. Fecal HPSA test shows high sensitivity and specificity, which is a simple, reliable and non-invasive method in the diagnosis of H. pylori infection, especially appropriate for children.