酶免疫法检测幽门螺杆菌粪便抗原及临床意义

Enzyme immune assay for detecting the helicobacter pylori stool antigen and its clinical significance

目的 探讨酶免疫法 (ELISA)检测幽门螺杆菌 (H pylori)粪便抗原的特异性及敏感性。 方法 用酶免疫试剂盒对 10 9例接受胃镜检查并取活检组织的患者粪便标本进行H pylori粪便抗原检测 ,确认试验为胃粘膜组织H pylori培养或 /和尿素酶试纸快速试验及H pylori形态学 (涂片检查、组织学染色 )检查 ,若结果均阳性则确认为H pylori感染。将粪便抗原检查结果与确认试验的结果比较 ,判断其敏感性、特异性和准确性。 结果 10 9例患者中确认为H pylori阳性的 6 9例 ,阳性率为 6 3 3% ,其中消化性溃疡、胃炎、胃癌的阳性率分别为 6 2 2 %、 6 7 9%、5 7 1%。H pylori阳性的 6 9例患者中H pylori粪便抗原阳性的 6 6例 ;H pylori阴性的 40例患者中H pylorio粪便抗原阴性的 38例 ,其敏感度为 95 7%、特异度为 87 5 %、准确度为 92 7%。kappa一致性系数k =0 84。结论 酶免疫法检测H pylori粪便抗原 ,方法可靠 。

Objective To study the sensitivity and specificity of enzyme immune assay for detecting the H.pylori stool antigen.Methods The H.pylori stool antigen from 109 patients who received gastroscope examination and biopsy were detected by enzyme immune assay,it was confirmed a diagnostic test of H.pylori cultivation test,rapid urease test,and H.pylori morphological examination.H.pylori state was defined as positive when two of the three tests(culture,morphology and rapid urease test)were positive.The sensitivity and specificity were evaluated while comparing the results of the H.pylori stool antigen with that results of confirmed diagnosis test.Results H.pylori positive rate was 63.3%,the positive rate of peptic ulcer,gastritis and gastric carcinoma were 62.2%,67.9%,57.1% respectively.The patients with the positive H.pylori stool antigen(66 cases) were diagnosed as H.pylori infection,the patients with the negative H.pylori stool antigen (38 cases) were confirmed negative patients.The sensitivity was 95.7%(66/69).The specificity was 87.5%(35/40).The overall accuracy was 92.7%.Conclusion Enzyme immune assay for detecting the H.pylori stool antigen is a simple,accurate,direct method and it is easy to be extended.