采用不同方法检测幽门螺杆菌的感染情况

Detection of Helicobacter Pylori Infection by Using Different Methods

目的探讨几种不同方法检测幽门螺杆菌感染的临床效果,分析幽门螺杆菌感染与性别、年龄及疾病的相关性。方法选取2012年8月至2014年8月在我院消化科门诊就诊的806例患者,分别采用尿素呼气试验法,免疫胶体金法以及病理组织切片染色镜检进行检测,以尿素呼气试验法作为金标准,比较免疫胶体金法与病理组织切片染色镜检法检测Hp的阳性预期值、阴性预期值、敏感度、特异性并比较不同性别、不同年龄及不同疾病Hp的感染率。结果 Hp检出率为37.5%,其中男性感染率为37.3%,女性为37.7%,差异无统计学意义(P>0.05);随着年龄增长Hp感染率有升高趋势,差异有统计学意义(P<0.05);确诊为慢性胃炎、消化性溃疡、胃息肉、胃癌的Hp感染率分别为48.6%、50.2%、21.6%、13.8%,慢性胃病的发生与幽门螺杆菌感染有一定的关联。免疫胶体金法以及病理组织切片染色镜检的敏感度分别为83.77%、93.05%,特异性分别为75.20%、83.53%,阳性预期值分别为66.93%、77.20%,阴性预期值为分别为88.55%、95.25%。结论胶体金法适用于大批量的流行病学调查,病理组织切片染色镜检敏感性高,可作为Hp感染筛查的方法之一。Hp感染率与年龄、疾病种类相关,与性别无关,为幽门螺杆菌感染的流行病学资料提供依据。

Objective To explore the clinical effect of different methods on detection of Helicobacter pylori （Hp） infection and to analysis the correlation between Helieobacter pylori infection and sex, age and disease states. Methods 806 cases of patients were involved in this study for Helicobacter pylori infection detection by using urea breath test, colloidal gold method and pathological tissue staining. The urea breath test was used as the gold standard, and the results from the remaining two detection methods were compared to determine the Hp positive values, negative expected value, sensitivity and specificity. The infection rates of Hp among different gender, age and disease states were analyzed. Results The positive rate of Hp infection was 37.5 % , the male and female infection rate was 37.3% and 37.7%, without significantly difference （P 〉 0.05 ）. The infection rate of Hp was increased as ages increased （ P 〈 0.05 ）. The Hp infection rates in patients with chronic gastritis, peptic ulcer, gastric polyps and gastric cancer were 48.6% , 50.2%, 21.6% and 13.8% respectively. The occurrence of chronic gastritis had certain correlation with Helicobacter pylori infection. The sensitivity and specificity of Hp infection detection for colloidal gold method and pathological tissue staining were 83.77% , 93.05% and 75.20%, 83.53% respectively. The positive values for both methods were 66.93% and 77. 20%, and the negative values were 88.55% and 95.25%. Conclusion The colloidal gold method might be applicable to large quantities of epidemiological investigation. The pathological tissue sections stained microscopy with high sensitivity could be used as an Hp infection screening method. The Hp infection rate may be related with age and diseases.