87例胃部疾病患者胃黏膜幽门螺杆菌检查方法比较

Comparison of examination methods for Helicobacter pylori on gastric mucosa in 87 patients with gastric diseases

目的探讨细菌分离培养与形态观察、快速尿素酶实验(RUT)以及16SrDNA的PCR扩增3种方法在幽门螺杆菌(Hp)感染检查中的优缺点。方法对胃镜下所见胃炎、消化性溃疡患者取其病变部位胃黏膜活检标本进行Hp的分离培养、快速尿素酶实验、并提取活检组织DNA进行16SrDNA PCR扩增及1%琼脂糖电泳。结果根据该实验设立的阳性标准判断,87例病例中Hp感染阳性为54例,检出率达到为62.1%(54/87),其中分离培养阳性率约41.4%(36/87),敏感性为66.7%,总符合率为79.3%;尿素酶检查阳性率约73.6%(64/87),敏感性性为100%,总符合率为88.5%;PCR扩增阳性率约65.5%(57/87),敏感性性为100%,总符合率为96.6%。结论三种检查方法中PCR敏感性和总符合率均较高,是较为准确、省时和简便的Hp检查方法。

Objective To explore the merits and demerits of such examination methods for Helicobacter pylori（Hp） as isolated culture of bacteria and morphologic observation,rapid urease test（RUT）,and polymerase chain reaction（PCR） amplification of 16SrDNA.Methods Biopsy specimens of stomach mucosa were taken under a gastroscope from the diseased regions of the patients with gastritis or peptic ulcer.Then we isolated culture of Hp,RUT,and 16SrDNA PCR amplification and 1% agarose electrophoresis were performed respectively.Results According to the positive standard of this study,among the 87 patients,54 patients were detected with Hp positive infection,with the detection rate of 62.1%（54/87）.The positive rate of isolated culture of Hp was about 41.4%（36/87）,with the sensitivity of 66.7% and the total coincidence of 79.3%;the positive rate of RUT was about 73.6%（64/87）,with the sensitivity of 100% and the total coincidence of 88.5%;the positive rate of PCR amplification was about 65.5%（57/87）,with the sensitivity of 100% and the total coincidence of 96.6%.Conclusion Among the three examination methods for Hp infection,the sensitivity and total coincidence of PCR are the highest,therefore,PCR is an accurate,time saving,simple and convenient method to examine Hp infection.