蛋白芯片技术在儿童幽门螺杆菌感染诊断中的应用

Value of protein array in the diagnosis of Helicobactor pylori infection in children

目的探讨幽门螺杆菌(HP)抗体检测蛋白芯片技术在儿童HP感染诊断中的应用价值。方法本院经胃镜检查的120例患儿,行快速尿素酶试验(RUT)及组织切片Giemsa染色。同时采用HP抗体蛋白芯片检测患儿血清中抗CagA、抗VacA、抗Ure、抗Hsp60及抗RdxA IgG抗体。以RUT及Giemsa染色两项均阳性作为HP感染阳性的诊断金标准。结果 120例患儿中,确诊HP感染阳性者60例。Ure抗体、Ure+CagA抗体、Ure+VacA抗体及Ure+CagA+VacA抗体均阳性对HP感染的诊断价值与金标准比较,吻合度和Kappa一致性检验均有统计学意义(P<0.001)。其中Ure+CagA抗体诊断的敏感性为81.7%,特异性为91.7%,准确度为86.7%,阳性预测值为90.7%,阴性预测值为83.3%,诊断HP现症感染最具临床价值。结论 HP蛋白芯片抗体检测,特别是Ure结合CagA抗体检测,对诊断HP感染有较高的临床价值,可作为HP现症感染的诊断方法。

Objective To study the value of multiple Helicobacter pylori（H.pylori） antibody detection by protein array in the diagnosis of H.pylori infection in children. Methods Biopsy specimens obtained by gastroscopy from 120 children with digestive system symptoms were detected by rapid urease test（RUT） and modified Giemsa staining.Positivity in both RUT and Giemsa staining was the ＂gold criterion＂ of H.pylori infection.Serum samples of these patients were obtained and the antibodies against cytotoxin associated gene A protein（CagA）,vacuolating toxin A（VacA）,urease,heat shock protein 60（Hsp60） and RdxA（nitroreductase） were detected by protein array technique. Results H.pylori infection was identified according to the ＂gold criterion＂ in 60 children.Compared with the ＂gold criterion＂,the goodness of fit and the coefficient of contingency in the diagnosis of H.pylori infection of the following four groups antibody detection were all statistically significant（P0.001）： anti-Ure antibody alone,anti-Ure antibody combined with anti-CagA antibody,anti-Ure antibody combined with anti-VacA antibody and anti-Ure antibody combined with anti-CagA and anti-VacA antibody.The sensitivity,specificity and accuracy of the detection of anti-Ure antibody combined with anti-CagA antibody for the diagnosis of H.pylori infection were 81.7%,91.7% and 86.7%,respectively.The antibody detection showed a high positive predictive value（90.7%） and a high negative predictive value（83.3%）. Conclusions The antibody detection by protein array,especially the detection of anti-Ure antibody combined with anti-CagA antibody,is valuable in the diagnosis of H.pylori infection.