幽门螺杆菌5种检测方法的比较

Comparison of 5 different detection methods for Helicobacter pylori

目的通过对5种幽门螺杆菌检测方法的比较,为临床选择检测方法提供参考。方法检查前留取粪便标本,检查时在胃窦和胃体钳取黏膜组织并抽血2 ml,采用快速尿素酶试验法、胃黏膜组织染色法、血清抗体检测法、13C-尿素呼气试验(13C-UBT)和粪便抗原(Hp SA)检测法对458例消化道疾病患者进行幽门螺杆菌检测,比较不同方法的敏感度、特异度、准确度以及与诊断标准的吻合度。结果在5种检测方法中,病理切片染色的灵敏度最高,达0.983,血清抗体检测灵敏度最低,仅为0.899,总体差异有统计学意义(P<0.05);13C-UBT特异度最高,达0.906,血清抗体检测特异度最低,只有0.801,总体差异有统计学意义(P<0.05);13C-UBT准确度最高,为0.951,各方法总体差异有统计学意义(P<0.05);5种方法的k值均>0.8。结论 5种方式均为幽门螺杆菌的有效检测方法,其中13C-UBT具有较高的诊断价值,临床应用时需结合个体情况选择合适的检测方法。

Objective To provide reference for clinical detection method choosing by comparing to the detection methods of helicobacter pylori（Hp）. Methods Before the examination, to sample stool specimens; during inspection, from the mucosal tissue of gastric antrum and body of stomach, to sample blood 2 ml with clamp. By rapid urease test, gastric mucosa staining, ser- um antibody detection method, ^13C urea breath test （ ^13C - UBT） and stool antigen （HPSA） detection method, 458 cases of gastrointestinal diseases were detected for Helicobacter pylori, and to compare the sensitivity, specificity, accuracy and and the degree of agreement with diagnostic criteria in different methods. Results The W - S section staining had the highest sensitivity （0.983）, the ELISA technique had the lowest sensitivity（0.899 ）. The difference was statistically significant （P 〈 0.05 ）. The ^13C - UBT had the highest specificity（0. 906）, the ELISA technique had the lowest specificity（0.801 ）. The difference was sta- tistically significant（P 〈 0.05 ）. ^13C - UBT also had the highest accuracy （0. 951 ）, the difference was statistical significant （P 〈 0.05）. The Kappa value was more than 0.8 of all methods. Conclusion All the 5 methods are effective to Hp detection, among them ^13C -UBT has the highest diagnostic value. Individual condition should be considered during clinical application.