^(13)C尿素呼气试验检测幽门螺杆菌感染的临床应用

Analysis of clinical application of^(13)C-urea breath test for detection of Helicobacter pylori infection

目的探讨^(13)C尿素呼气试验检测幽门螺杆菌感染的临床诊断价值。方法选择2022年1月至2023年7月100例上海未凡医学检验实验室接受检查的上腹部不适患者100例作为研究对象。所有患者均行快速脲酶试验(RUT)和^(13)C尿素呼气试验。以组织学检查作为诊断金标准,比较2种方法对患者各种疾病诊断的准确性、阳性率。对2种方法的诊断性能(灵敏度、特异度、准确性、阴性预测值、阳性预测值)进行评估。结果100例上腹部不适患者中,90例经病理检查确诊。^(13)C尿素呼气试验对十二指肠炎和消化性溃疡的诊断阳性率高于RUT(P<0.05)。2种方法对胃息肉、慢性胃炎、胃癌的诊断阳性率比较,差异无统计学意义(P>0.05)。与RUT相比,^(13)C尿素呼气试验具有更高的灵敏度、特异度、准确性、阳性预测值和阴性预测值。2种方法的特异度、准确性差异有统计学意义(P<0.05),而敏感性、阴性预测值、阳性预测值差异无统计学意义(P>0.05)。结论^(13)C尿素呼气试验和RUT均是检测幽门螺杆菌感染的有效诊断方法,但^(13)C尿素呼气试验具有更高的诊断阳性率和整体诊断效能。

Objective To study the clinical diagnostic value of the^(13)C-urea breath test in detecting Helicobacter pylori infection.Methods We selected 100 patients with upper abdominal discomfort who presented to the laboratory for examination from January 2022 to July 2023.All patients underwent rapid urease test(RUT)and^(13)C-urea breath test.Histological examination was used as the diagnostic gold standard to compare the diagnostic accuracy of the two methods for various diseases in patients,including the diagnostic positive rate.The diagnostic performance of the two methods(sensitivity,specificity,accuracy,negative predictive value,positive predictive value)was assessed.Results Among the 100 patients with upper abdominal discomfort,90 cases were confirmed by pathological examination.The^(13)C-urea breath test had a higher diagnostic positive rate for duodenitis and peptic ulcers compared to RUT(P<0.05).There was no significant difference in the diagnostic positive rate between the two methods for gastric polyps,chronic gastritis,and gastric cancer(P>0.05).The^(13)C-urea breath test had higher sensitivity,specificity,accuracy,positive predictive value,and negative predictive value compared to RUT.The specificity and accuracy of the two methods were significantly different(P<0.05),while the sensitivity,negative predictive value,and positive predictive value were not significantly different(P>0.05).Conclusion Both the^(13)C-urea breath test and RUT are effective diagnostic methods for detecting Helicobacter pylori infection,but the^(13)C-urea breath test has a higher diagnostic positive rate and overall diagnostic performance.