中国检验幽门螺杆菌感染方法诊断效能的分析

Analysis of different diagnostic methods of Helicobacter pylori infection in China

目的:对有关幽门螺杆菌(H pylori)感染诊断方法的研究文献进行分析,评价感染H pylori诊断方法的诊断效能.方法:检索1994-2005的H pylori感染诊断方法的文献资料,对检索到的相关文献按诊断方法种类分别进行原始数据合并,然后对10种诊断方法的灵敏度(Se)、特异度(Sp)、正确率(π)进行分析.结果:有56项研究符合选择标准,综合评价结果如下,H pylori培养试验:Se为78.39%,Sp为89.13%,π为86.51%:病理组织学切片检查:Se为91.47%,Sp为93.98%,π为91.89%;^(13)C-尿素呼吸试验:Se为95.49%,Sp为94.76%,π为95.53%;^(14)C-尿素呼吸试验:Se为96.38%,Sp为90.80%,π为94.34%;血清抗H pylori-IgG的ELISA法试验:Se为92.04%,Sp为87.70%,π为98.83%;快速尿素酶诊断:Se为88.14%,Sp为89.08%,π为88.42%;胃黏膜涂片法诊断试验:Se为94.53%,Sp为95.56%,π为96.65%;PCR法试验:Se为97.57%,Sp为89.09%,π为95.44%;H pylori粪便抗原试验(H pylori SA)-酶免疫法:Se为95.57%,Sp为93.17%,π为94.24%;唾液抗H pylori-IgG试验Se为93.06%,Sp为86.96%,π为91.32%.结论:目前临床常用的各种诊断方法诊断效能对比显示,各种诊断方法各有优缺点.临床上采用何种诊断方法,应根据具体情况和不同要求来决定.

AIM： To analyze the literatures about diagnostic methods for H pylori infection in China, and to evaluate the values of different diagnostic methods. METHODS： The literatures, published from 1994 to 2005 on this topic, were collected. The sensitivity, specificity, and accuracy of 10 diagnostic methods for H pylori infection were generally analyzed. RESULTS： A total of 56 related papers were included according to the selective standard. The sensitivity, specificity and accuracy were 78.39%, 89.13%, and 86.51% for H pylori culture test; 91.47%, 93.98%, and 91.89% for pathological examination; 95.49%, 94.76%, and 95.53% for ^13C-urea breath test; 96.38%, 90.80%, and 94.34% for ^14C-urea breath test; 92.04%, 87.70%, and 98.83% for anti-H pylori-IgG test （using enzymelinked immunosorbent assay）; 88.14%, 89.08%, and 88.42% for rapid urease test; 94.53%, 95.56%, and 96.65% for gastric mucosa smear; 97.57%, 89.09%, and 95.44% for polymerase chain reaction; 95.57%, 93.17%, and 94.24% for stool-antigen test; 93.06%, 86.96%, and 91.32% for anti-H pylori-IgG test in saliva, respectively. CONCLUSION： Advantages and disadvantages co-exist in the different diagnostic methods for H pylori infection at present, and the choice should be made depending on the actual situation and demands.