3种幽门螺杆菌检测方法的临床评价

Clinical value of three kinds of helicobacter pylori detection methods

目的探讨3种幽门螺杆菌(HP)检测方法的临床价值,寻找更适合临床推广的快速HP检测方法。方法对该院行胃镜检查的109例患者,分别用多点、多部位胃黏膜取材行快速尿素酶试验(RUT)、13 C呼气试验(13 C-UBT)及HP粪便抗原(HpSA)免疫快检卡检测HP感染,比较其检测效果。结果两块胃黏膜(胃窦+胃体)RUT阳性率为34.86%,高于单块胃黏膜(胃窦或胃体)、两块胃黏膜(胃体),差异均有统计学意义(P<0.05);以13 C-UBT为"金标准"诊断HP感染,两块胃黏膜(胃窦+胃体)敏感性、准确性分别为72.97%、80.73%,高于两块胃黏膜(胃窦),低于四块胃黏膜(两块胃窦+两块胃体)。RUT、13 C-UBT及HpSA免疫快检卡阳性率两两间比较差异均无统计学意义(P>0.05);以13 C-UBT为"金标准"诊断HP感染,HpSA免疫快检卡敏感性、特异性、准确性分别为86.49%、95.83%、92.66%,均高于RUT。结论两块胃黏膜(胃窦+胃体)取材是更适合临床推广的RUT取材方案。RUT、13C-UBT及HpSA免疫快检卡均为临床快速HP检测的可靠方法,但HpSA免疫快检卡更适合临床推广。

Objective To discuss the clinical value of three kinds of helicobacter pylori （HP） detection methods and find out the appropriate method for clinical application of the HP detection .Methods A total of 109 patients received gastroscopy ,the efficacy of RUT ,13C-urea breath test（13C-UBT） and the immunoCard STAT helicobacter pylori stool antigen （HpSA） for detection of HP were compared .Results RUT positive rate of the two pieces of gastric mucosa （the gastric antrum and the gastric body） was 34 .86% ,higher than that of single piece of gastric mucosa （gastric antrum or stomach body ） and two pieces of gastric mucosa （stomach） ,the difference was statistically significant （P〈0 .05）;The diagnosis of HP infection was based on 13 C-UBT ,sensitivity and accuracy of the two pieces of gastric mucosa （the gastric antrum and the gastric body） were 72 .97% and 80 .73% ,respectively , higher than that of two pieces of gastric mucosa and gastric antrum ,and lower than the four pieces of gastric mucosa （two pieces of gastric antrum ＋ two pieces of the gastric body） .There was no statistically significant difference among RUT ,13 C-UBT and the immunoCard STAT HpSA（P〉0 .05） .The diagnosis of HP infection was based on 13C-UBT ,the immunoCard STAT HpSA sensi-tivity ,specificity and accuracy were 86 .49% ,95 .83% ,92 .66% ,respectively ,which were higher than RUT .Conclusion Two pieces of gastric mucosa （the gastric antrum and the gastric body） materials is appropriate for clinical promotion RUT based solution . RUT ,13C-UBT and hpsas immune quick check card are all clinical detection of HP and reliable methods ,but hpsas immune quick check card is more suitable for clinical promotion .