应用血清学及^(13)C-尿素呼吸试验对幽门螺杆菌家庭感染状况的研究

Familial Infection Status of Helicobacter Pylori by Serology and ^(13)C- Urea Breath Test

目的 研究一级亲属幽门螺杆菌 (helicobacterpylori,HP)感染状况以及其对儿童HP感染的影响。方法 应用血清学及13 C -尿素呼吸试验 (13 C -ureabreathtest,13 C -UBT)测定反复腹痛儿童及父母的HP感染情况。结果 13 C -UBT及血清HP -IgG测定家庭的HP感染率分别为 41 .6 %和 76 .5 % ,显著高于腹痛儿童的HP感染率 2 9.5 %和 5 4.8% (P <0 .0 5和P <0 .0 0 5 )。儿童13 C -UBT及血清学阳性时 ,其家庭HP感染率分别为83.7%和 85 .7% ,显著高于其儿童阴性时的家庭HP感染率 2 3.9%和 6 5 .3% ;家庭13 C -UBT及血清学阳性时 ,其儿童HP感染率分别为 5 9.4%和 6 1 .4% ,也显著高于其家庭阴性的儿童HP感染率 8.3%和 33.3% ,P <0 .0 0 5。血清学检查的敏感性为 94.2 % ,特异性 36 .1 %。结论 一级亲属有HP带菌的家庭中儿童HP症状性感染率高 ,HP感染有明显的家庭聚集性。血清HP -IgG检测敏感性好 ,特异性差 ,13 C -UBT比血清学检测更能反应HP家庭实时感染状况。

Objective To study familial infectious status of helicobacter pylori (HP) and its effect on the rate of HP infection in children in the same household. Methods Children with abdominal pain and their parents were detected in the way of serology and 13 C -urea breath test (UBT). Results The HP infection rate of the family of 13 C-UBT and serologic HP-IgG was 41.6% and 76.5% respectively, higher than that of children with recurrent abdominal pain, which was 29.5% and 54.8% respectively (P<0.05 and P<0.005). The familial HP infection rate when children were HP positive by 13 C-UBT and serology was 83.7%and 85.7% respectively, much higher than that when children were HP negative, 23.9% and 65.3% respectively; the children's HP infection rates (59.4% using 13 C-UBT and 61.4% using serology) of the family with HP positive were also much higher than that of the family with HP negative, which was 8.3% using serology and with 33.3% using 13 C-UBT, (P<0.005). The sensitivity of serology was 94.2% , and the specificity was 36.1%. Conclusions The symptomatic infection rate of HP in children is high when there is HP infection in family members, 13 C-UBT better reflects the infectious status of HP in a particular family.