快速微量^(14)C-尿素呼吸试验诊断幽门螺杆菌感染

Rapid Microdose 14 C urea Breath Test for Detection of Helicobacter Pylori Infection

为简化检查程序，降低检查成本和受检者接受的辐射剂量，建立了一种快速微量简便的１４Ｃ－尿素呼吸试验（１４Ｃ－ＵＢＴ）。对１５７例未经抗菌治疗的溃疡、胃炎等上消化道疾病患者，以组织学检查（Ｇｉｅｍｓａ染色）和快速尿素酶试验为诊断幽门螺杆菌感染的金标准。患者禁食４小时，于口服３７ｋＢｑ１４Ｃ－尿素前和口服之后１０、２０和３０分钟分别采集呼出气体标本，液闪测定。结果显示以等于或大于２００ｃｐｍ为阳性诊断标准，１４Ｃ－ＵＢＴ的敏感性、特异性、阳性预测值、阴性预测值和正确率分别为９４．７９％，９０．１６％，９３．８１％，９１．６０％和９２．９９％。由此可见３７ｋＢｑ１４Ｃ－尿素，１０分钟采集一次呼出气体标本，以等于或大于２００ｃｐｍ为阳性诊断标准，既能降低辐射剂量和成本，又能获得高准确性的诊断，是值得在临床推广应用的简便方法。

The purpose of this study was to develop and evaluate a rapid microdose 14 C urea breath test ( 14 C UBT) with a simplified protocol for detecting the infection of hilicobacter pylori (HP). 157 fasting patients who underwent endoscopy with histological examination and rapid urease test (RUT) were given a drink of 37 kBq of 14 C urea. Samples of breath carbon dioxide (1mmol) were collected at baseline and 10,20 and 30 min after administration by trapping in hyamine solution. 14 C activity was meas ured by liquid scintillation counting. Results were expressed as cpm. Histolal examination and RUT were used as gold standard for the detection of HP infection. The cutoff value was selected as 200 cpm at 10 min. The results showed that the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 94.79%, 90.16%, 93.81%, 91.60% and 92.99% respectively. In this study, a 10min, single sample, 37 kBq 14 C urea breath test for detection HP was developed. The test has good diagnostic accuracy with minimal radiation exposure and low cost. Thus, the authors considered the test to be reliable, safe, convenient and cost effective to clinical use.