唾液测试板检测幽门螺杆菌感染的临床价值

Clinical value of saliva test plate for Helicobacter pylori detection

目的探讨唾液测试板检测幽门螺杆菌(Hp)感染的临床价值。方法采用唾液测试板检测患者唾液中的尿素酶,同时用快速尿素酶试验(RUT)、胃黏膜组织学检查(改良Giemsa染色)、14C-尿素呼气试验(14C-UBT)及细菌培养联合检测来判断胃黏膜Hp感染情况。结果80例患者行Hp联合检测检出阳性患者51例,阳性率为63.75%,其中唾液测试板检出38例,阳性率47.50%,RUT检出45例,阳性率56.25%,组织学检查检出47例,阳性率58.75%,14C-UBT检出47例,阳性率58.75%,细菌培养检出38例,阳性率47.50%。唾液测试板、RUT、组织学检查、14C-UBT及细菌培养诊断Hp感染的敏感性分别为72.55%、80.39%、88.24%、80.39%、74.51%;特异性分别为96.55%、86.21%、93.10%、79.31%、100.00%;准确性分别为81.25%、82.50%、90.00%、80.00%、83.75%;阳性预测值分别为:97.37%、91.11%、95.74%、87.23%、100.00%;阴性预测值分别为66.67%、71.43%、81.82%、69.70%、69.05%,结果进行χ2检验,差异无显著性。结论唾液测试板检测唾液中Hp感染的阳性率及准确性、敏感性、特异性与RUT等相近,且此法为非侵入性、快速、简便,价格不高,不需要任何其他仪器,是值得临床进一步验证的一种新的非侵入性Hp感染诊断方法。

[ Objective ] To explore the clinical value of the saliva test plate in detection of Helicobacter pylori （Hp）. [Methods] Saliva test plate was used to detect urease in saliva of patients. Hp infection in biopsy specimen of gastric mueosa was detected with the combined tests of RUT, modified Giemsa staining, 14C urease breath test （14C-UBT） and bacterial euhure at the same time. [Results] In 80 patients, 51 cases were detected to be positive by the combined tests with the positive rate of 63.75%. For saliva test plate, RUT, modified Giemsa staining, 14C-UBT and bacterial cultures, the positive rates were 47.50%, 56.25%, 58.75%, 58.75%, 47.50%, respectively; while their sensitivities for diagnosing Hp infection were 72.55%, 80.39%, 88.24%, 80.39%, 74.51%, respectively; their specifieities were 96.55%, 86.21%, 93.10%, 79.31%, 100.00%; the correct rates were 81.25%, 82.50%, 90.00%, 80.00%, 83.75%. The positive predictive rates were 97.37%, 91.11%, 95.74%, 87.23%, 100.00%, respectively; while the negative predictive rates were 66.67%, 71.43%, 81.82%, 69.70%, 69.05%,respectively. X2 test suggested that the differences were not statistically significant. [ Conclusions ] The positive rate, correct rate, sensitivity and specificity of detecting urease in saliva with saliva test plate are similar to those with RUT and other methods. This method is non-invasive, rapid, simple and cheap, does not require any other equipment and is worthy of further clinical confirmation as a new diagnostic method for Hp.