粪便抗原检测对幽门螺杆菌感染的诊断价值

Diagnostic value of the stool antigen test for Helicobacter pylori infection

目的 研究幽门螺杆菌粪便抗原 (HpSA)检测诊断幽门螺杆菌 (HP)感染的临床应用价值。方法 采用ELISA法检测 98例因上消化道症状接受胃镜检查病人的HpSA ,同时进行细菌培养 ,快速尿素酶试验和14 C 尿素呼气试验检查。将后三项检查中二项阳性或细菌培养一项阳性作为诊断HP感染的金标准。结果 金标准诊断HP感染 ,阳性 5 4例 ,阴性 4 4例。金标准阳性的 5 4例中 ,HpSA检测阳性为 5 1例 ,阴性为 3例 ;金标准阴性的 4 4例中 ,HpSA检测阴性为 4 2例 ,阳性为 2例。HpSA检测诊断HP感染的敏感度94 .4 % (5 1/ 5 4 ) ,特异度 95 .5 % (42 / 4 4) ,准确度94 .9% (93/ 98) ,阳性预测值 96 .2 % (5 1/ 5 3) ,阴性预测值 93.3% (42 / 4 5 )。结论 HpSA检测有较高的敏感性和特异性 ,是一种简便可靠 ,非侵入性的诊断HP感染的方法 ,易于临床推广。

Objective To research the clinical application value of the Helicobacter pylori stool antigen (HpSA) test in diagnosing Helicobacter pylori (H. pylori) infection. Methods Stool specimens were collected from 98 patients who had gastroscopy for gastrointestinal symptoms. A specific enzyme linked immunosorbent assay (ELISA) was used to test H. pylori antigen in the stool. H. pylori status was evaluated by four different tests: culture, rapid urease test, 14 C urea breath test and H. pylori stool antigen test.A combination detection (culture, rapid urease test and 14 C urea breath test) was regarded as 'gold standard'.Results Fifty four patients were diagnosed as H. pylori positive and forty four as negative by 'gold standard'. The HpSA test was positive in 51 of 54 patients and negative in 42 of 44 patients. The sensitivity,specificity, accuracy, positive predictive value and negative predictive value of HpSA test were 94.4 % (51/54), 95.5 % (42/44), 94.9 % (93/98), 96.2 % (51/53) and 93.3 % (42/45) respectively. Conclusion This study suggests that HpSA test is a simple, reliable, non invasive method and has highly sensitivity and specificity for detection of H. pylori infection.