在非溃疡性消化不良中ELISA法测抗幽门螺旋杆菌抗体的临床意义

Clinical Significance of an ELISA to Detect Anti Helicobacter Pylori in Non-ulcer Despepsia

非溃疡性消化不良(NUD, non-ulcer dyspepsia)是常见症候群,其病因尚未完全明了。NUD中幽门螺旋杆菌(HP Helicobacter Pylori)相关性胃炎占很大比例。针对该菌产生之抗体反应,应用酶联免疫法(ILISA)检测了335例NUD患者血清抗-HP抗体。其中208例为经细菌培养及(或)组织学检查证实的HP相关性胃炎,对其中164例进行前瞻性随机安慰剂对照研究,以评价胶态次枸橡酸铋加氟哌酸治疗效果.治疗组与安慰剂组HP清除率分别为69％与6％(P<0.01)。HP清除后患者胃粘膜炎症好转或消除,症状明显减轻,抗-HP抗体滴度下降。

Non-ulcer dyspepsia(NUD) is a common complaint. Little is known about the patho- genesis of the syndrome. It is intriguing to note the high incidene of helicobacter pylori(HP) infection in NUD. which is associated with a local antibody response directed against the or- ganism. An enzyme-linked immunosorbent assay (ELISA) detection of Ig G antibodies a- gainst HP was used to examine sera from 335 patients with NUD. 208 patients had HP-asso- ciated gastritis according to culture or histology. 164 patients with NUD were studied in a prospective randomized placebocontrolled study to assess the effieacy of colloidol bismuth subcitrate (CBS, 0. 11 qid, for 1 month) plus norfloxacin (0. 2 tid, for 1 month). HP was cleared in 85% of CBS-Norfloxacin-treated patients compared with only 6% placebo(P< 0. 01). Both acute and chronic inflammation improved in patients cleared of bacteria. Clear- ance of HP and histological improvement was associated with a significant decrease in symp- toms and antibody titres to HP after treatment.