三种抗原检测抗幽门螺杆菌抗体的临床意义评价

Evaluation on the clinical diagnosis of various HP antigens for detection of anti HP antibodies by DIGFA

目的：寻求敏感性高、特异性强的ＨＰ抗原和简便、可靠的检测ＨＰ抗体的方法，用于诊断ＨＰ感染。方法：分别以ＨＰ尿素酶、全菌破碎物、培养上清液为抗原。采用斑点金标免疫渗滤法（ＤＩＧＦＡ）检测ＨＰ培养、病理组织学检查、尿素酶试验均阳性和均阴性的血清各５０份；胃镜检查各类胃病患者血清２５８份，并以ＥＬＩＳＡ试剂盒做平行检测对照。结果：三种抗原的敏感性分别为１００％、９６％和７６％；５０份阴性血清的阴性符合率分别为９８％、９２％和６４％；２５８份各类胃病的抗体检出率分别为６１％、６２％和５２％；与ＥＬＩＳＡ符合率各为９８８％、９６５％和５８９％。将抗原浓度稀释至００５ｍｇ／ｍｌ时，尿素酶抗原和全菌破碎物抗原的特异性抗体检出率仍达８５％和７５％。培养上清液抗原的敏感性和特异性明显低于前二种抗原（Ｐ＜００１）。尿素酶抗原和全菌破碎抗原的敏感性和特异性明显低于前二种抗原（Ｐ＞００５）。结论：提示该全菌破碎物抗原用于ＤＩＧＦＡ检测ＨＰ抗体、敏感性高、特异性强，且简便、快速、无需任何仪器设备。适合于临床和流行病学调查应用。

Objective:To select available Helicobacter pylori(HP)antigens and develop a simple and reliable assay for detection of HP infection,with high sensitivity and specificity.Methods:Urease,crude abstract of whole HP,supernatant of HP culture were used as antigens to detect anti HP antibodies in serum by Dot Immunogold Filtration Assay(DIGFA).50 sera from patients infected with HP,50 sera from normal adult and 258 sera from out patients with various stomach troubles were tested using three antigens by DIGFA,respectively and paralleled with results of ELISA kit.Results:Sensitivities of three antigens were 100%,96% and 76%,specificities of them were 98%,92% and 64%,respectively.Positive rates of 258 sera from out patients were 61%,62% and 52% when detected using three antigens.Coincidental rate with ELISA were 98.8%,96.5% and 58.9%,when the concentration of antigens was 0.05 mg/ml,the positive predictive rates using urease,crude abstract antigens were still as high as 85% and 75%.The sensitivity and the specificity of supernatant of HP culture antigen were significantly lower than those of urease antigen and crude abstract antigen( P< 0.01).There is no significant difference between those of urease and crude abstract antigens( P> 0 05).Conclusion:It suggested that the crude abstract of whole HP is an available antigen with high sensitivity and specificity for detection of HP infection by DIGFA,which is fitful to clinical diagnosis and epidemiological investigation.