^(14)C-尿素呼气试验及其评价

Detection of Helicobacter Pylori by 14 C Urea Breath Test

为了进一步评价１４Ｃ－尿素呼气试验（１４Ｃ－ｕｒｅａｂｒｅａｔｈｔｅｓｔ，１４Ｃ－ＵＢＴ）的临床诊断价值。５８例ＵＢＴ检测患者同时作快速尿素酶试验和细菌培养检测幽门螺杆菌（Ｈｐ），其中１３例在口服１４Ｃ－尿素胶囊后不同时间分别检测呼气中１４ＣＯ２活度。经受试者工作特征曲线（ＲＯＣ）分析，ＵＢＴ诊断临界值可在１５０～２００ｍｉｎ－１之间，其敏感性、特异性与快速尿素酶试验（ＲＵＴ）、细菌培养并行检测相当。患者呼气中１４ＣＯ２活度时间动态变化为Ｈｐ阳性５ｍｉｎ时即迅速上升，２０～５０ｍｉｎ时达到高峰，Ｈｐ阴性在所观察的２ｈ内未见有明显变化，这些结果提示ＵＢＴ是诊断Ｈｐ感染十分可靠和简便的一种方法。

In order to evaluate 14 C Urea breath ( 14 C UBT) in the detection of helicobacter pylori (Hp), 58 patients got 14 C UBT, and the test results were compared with culture for Hp and rapid urease test(RUT). Diagnosis of Hp infection was made with one positive test of the two tests. Samples of breath carbon dioxide of 13/58 patients were collected at 0, 5, 10, 20, 30, 40, 50, 60, 80, 100 and 120 min later by trapping in hyamine solution, and 14 C activity was measured by liquid scintillation counting, samples of breath carbon dioxide of 45/58 cases were only collected at 20 min and then measured. Using receiver operator characteristic (ROC) analysis, when sensitivity and specificity of 14 C UBT were 97.4% and 100%, the cut off value was 150￣200 min -1 at 20 min. Observing time dynamic change of 14 C activity of samples breath, it began to rise rapidly at 5 min and reached the peak (205￣4 807 min -1 ) at 20￣50 min in Hp infection positive cases, and was of no obvious change (near background) in two hours observing in Hp infection negative cases. These results suggest that 14 C UBT is accurate, simple, rapid, and convenient for diagnosis of Hp infection.