检测幽门螺旋杆菌感染的几种方法的比较

Comparative evaluation of experimental methods for detecting Helicobacter pylori infection

目的 :评价几种诊断幽门螺杆菌 (Hp)感染的检测方法 .方法 :对 386例患者行胃镜钳取胃窦粘膜 ,分别经改良Giemsa染色、快速尿素酶 (RUT)试验、14 C 尿素呼气试验 (14 C UBT)检查及HpIgG血清学检查 ,与细菌培养结果对照 ,用 χ2检验进行对比评价 .结果 :RUT ,14 C UBT和改良Giemsa染色的敏感性、特异性较高 ,与细胞培养的符合率相近 ,其中14 C UBT和改良Giemsa染色联合检测的符合率更相近 (99.7% ) ;HpIgG血清学检查的敏感度虽和其余检测方法无差别 ,但其特异度较低 ,尤其是复诊组的特异度 ,与其他检测方法有显著差异 (P <0 .0 1) ,而且与初诊组相比也有差异 (χ2 =35 .18,P <0 .0 1) .结论 :HpIgG血清学检查可用于Hp感染的筛查 ,而不能作为疗效判断的指标 ,14 C

AIM: To evaluate some detecting methods with diagnostic value in the diagnosis of Helicobacter pylori (Hp) infection. METHODS: Antral biopsy specimens obtained by gastroscopy from 386 patients were detected with modified Giemsa stain and rapid urease test (RUT). The patients were also examined with 14 C urease breath test ( 14 C UBT) and serum Hp IgG antibody. Comparison was made with bacteria culture and these detecting methods were evaluated by χ 2 test. RESULTS: RUT, 14 C UBT and modified Giemsa stain detections had relatively higher sensitivity and specificity and produced similar result to that of bacteria culture. The result of modified Giemsa stain detection combined with 14 C UBT was more similar to that of bacteria culture (99.7%). Although the sensitivity of serum Hp IgG antibody examination was the same as those of other methods, its specificity was relatively lower, especially the specificity of the return visit group ( P <0.01), which was also different from that of the first visit group ( χ 2=35.18, P < 0.01 ). CONCLUSION: The Hp IgG antibody examination can be used in screening Hp infection, but not in evaluating the curative effect. The combined detection of 14 C UBT with modified Giemsa stain is comparatively more reliable in detecting Hp infection.