幽门螺杆菌粪便抗原检测法在胃肠疾病中的临床诊断价值研究

Study on diagnostic value of Helicobacter pylori stool antigen test in gastrointestinal diseases

目的研究幽门螺杆菌粪便抗原(HpSA)检测法在胃肠疾病中的临床诊断价值。方法196例胃肠疾病患者,采集患者的粪便样本以及胃窦区黏膜样本,分别开展HpSA检测法、快速尿素酶试验(RUT)联合组织学检测法。以RUT联合组织学检测结果为金标准,分析HpSA检测法的诊断效能。结果196例患者经RUT联合组织学检测法确诊123例患者感染幽门螺杆菌(Hp),73例未感染Hp,阳性率为62.76%(123/196)。以RUT联合组织学检测法为金标准,HpSA检测法检出阳性患者123例,阳性检出率为62.76%(123/196),灵敏度为97.56%(120/123)、特异度为95.89%(70/73)、阳性预测值为97.56%(120/123)、阴性预测值为95.89%(70/73)、诊断准确率为96.94%(190/196)。结论HpSA检测法在胃肠疾病中的诊断准确率、灵敏度和特异度均较高,可以将该诊断方法应用于儿童、老年人、胃癌家属的筛查中,同时对于不能进行13C-尿素呼气试验(UBT)或14C-UBT、组织学诊断的患者或地区也可以使用该方法。

Objective To study the diagnostic value of Helicobacter pylori stool antigen(HpSA)test in gastrointestinal diseases.Methods Fecal samples and mucosa samples from the antrum region were collected from 196 patients with gastrointestinal diseases,and HpSA test,rapid urease test(RUT)combined histological test were performed,respectively.The results of RUT combined histological test were used as the gold standard to analyze the diagnostic efficiency of HpSA.Results In 196 patients,123 patients were confirmed to be infected with Helicobacter pylori(Hp)by RUT combined histological test,and 73 patients were not infected with Hp,with a positive rate of 62.76%(123/196).Using RUT combined histology test as the gold standard,123 patients were detected positive by HpSA test,and the positive detection rate was 62.76%(123/196);the sensitivity was 97.56%(120/123),specificity was 95.89%(70/73),positive predictive value was 97.56%(120/123),negative predictive value was 95.89%(70/73),diagnostic accuracy was 96.94%(190/196).Conclusion HpSA has high diagnostic accuracy,sensitivity and specificity,which can be applied to the screening of children,the elderly and gastric cancer families,and can also be used in patients or regions without 13C-urea breath test(13C-UBT)or 14C-UBT and histological diagnosis.