酶联免疫吸附测定检测儿童粪便幽门螺杆菌抗原

The Clinical Application of ELISA Assay for Detection of Helicobacter Pylori Stool Antigen in Children

目的:探讨酶联免疫法检测粪便标本幽门螺杆菌抗原(HpSA)诊断儿童Hp感染的应用价值。方法:采用双抗体夹心酶联免疫吸附测定(ELISA)检测2005年1月至2006年1月门诊、住院的86例患儿怀疑Hp感染的粪便标本,同时与临床试验(快速尿素酶试验、13C-呼气试验)进行比较评价。结果:以快速尿素酶试验、13C-尿素呼气试验联合检测阳性为Hp感染的临床诊断标准,HpSA试验诊断准确率90.7%。粪便抗原试验的敏感度为87.9%,特异度为95.2%,阳性预测值为96.7%,阴性预测值为83.3%。经配对资料χ2检验,HpSA检测与联合检测结果差异无统计学意义(2χ=0.8,P>0.05,20χ.05=3.84)。HpSA试验与13C-尿素呼气试验检测结果差异无统计学意义(2χ=0.36,P>0.05),HpSA试验与快速尿素酶试验检测结果差异有统计学意义(2χ=4.92,P<0.05)。结论:粪便标本HpSA试验诊断儿童幽门螺杆菌感染有较高的准确率、敏感度和特异度,为新的简便易行的非侵入性方法。

Objective： To evaluate the value of Helicobacter pylori stool antigen （HpSA） test for diagnosis of hclicobacter pylori （Hp） infection in children. Methods： Stool specimens were detected by enzyme linked immunosorbent assay （ELISA） from children with symptoms of the upper digestive tract suspected of Hp infection. The detection results of the HpSA test were compared with the rapid urcase test and ^13C-urea breath test （^13 C-UBT）. Results： Based on positive results from rapid urease test and ^13C-UBT combined,the accuracy of diagnosis by HpSA detection was 90.7% with 87.9% sensitivity,95.2% specificity,96.7% prediction positivity and 83.3% prediction negativity. Significant difference was not found between HpSA test and ^13 C-UBT（x^2 = 0. 8, P 〉 0. 05 ,x^2 0.05 = 3.84） , but difference between HpSA test and RUT（x^2= 4. 92 ,P 〈 0.05 ）. Conclusions： The HpSA test for the diagnosis of Hp infection,was highly accurate, sensitive and specific,and therefore recommendable as a simple, economic, reliable and non-invasive method.