Stool antigen tests for the management of Helicobacter pylori infection

Stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(H.pylori)infection.Two types of SATs exist for the diagnosis of H.pylori infection,one based on enzyme immunoassay(EIA)and another on immunochromatography(ICA).SATs do not require expensive chemical agents or specified equipment;hence,they are less expensive compared with the urea breath test.Both European and Japanese guidelines have shown that EIA-based SATs using monoclonal antibodies are useful for primary diagnosis as well as for the assessment of eradication therapy.ICA-based tests do not require particular equipment and are therefore useful in developing countries.SATs are also useful for the diagnosis of H.pylori infection in children and post gastric surgery patients.SATs performed via EIA can assess H.pylori infection in a large number of subjects,almost as well as serology.Thus,SATs would be useful or detecting current infection in such a survey to identify and eradicate H.pylori infection.The accuracy of SATs is lower when the stool samples are unformed or watery,because H.pylorispecific antigens in the stool samples are diluted.Temperature and the interval between stool sample collection and measurement also affect the results of SATs.The choice of test kit depends on the sensitivity and specificity in each region and the circumstances of each patient.

Influence of proton pump inhibitor treatment on Helicobacter pylori stool antigen test

AIM: To investigate the effects of proton pump inhibitor (PPI) treatment on stool antigen test using the TestMate pylori enzyme immunoassay. METHODS: This study assessed 28 patients [16 men and 12 women; mean age (63.1 ± 5.9) years; range, 25-84 years] who underwent stool antigen test and urea breath test (UBT) before and after PPI administration. RESULTS: Using the UBT as the standard, the sensitivity, specif icity and agreement of the stool antigen test in all 28 patients were 95.2%, 71.4%, and 89.3%, respectively, before PPI administration, and 88.9%, 90.9%, and 89.3%, respectively, after PPI treatment. Mean UBT values were 23.98% ± 5.33% before and 16.19% ± 4.75% after PPI treatment and, in 15 patients treated for ≥ 4 wk, were signif icantly lower after than before 4 wk of PPI treatment (12.58% ± 4.49% vs 24.53% ± 8.53%, P = 0.048). The mean optical density (A450/630) ratios on the stool antigen test were 1.16 ± 0.20 before and 1.17 ± 0.24 after PPI treatment (P = 0.989), and were 1.02 ± 0.26 and 0.69 ± 0.28, respectively, in the group treated for > 4 wk (P = 0.099).

Comparison of invasive methods and two different stool antigen tests for diagnosis of H pylori infection in patients with gastric bleeding

AIM： To compare two different H pylori stool antigen tests as noninvasive diagnostic methods. METHODS： The study population consisted of 22 upper gastrointestinal system bleeding patients. Urea breath test （UBT）, rapid urease test （RUT） and histopathological examination were applied to all patients. Stool specimens from these patients were examined by rapid STPIP!HpSA and one step simple H pylori antigen cassette test for the detection of Hpylori antigens. RESULTS： For these 22 patients, 15 （68.2%） were diagnosed as positive and seven （31.8%） were diagnosed negative for H pylori infection by the gold standard methods. Whereas 10 （45.5%） were positive and 12 （54.5%） were diagnosed negative by the rapid STPIP!HpSA test. The sensitivity, specificity, positive and negative predictive values were 60%, 86%, 90% and 50%, respectively. When compared to the gold standard methods, these differences were not significant. However, six patients （27.3%） were positive, and 16 （72.7%） were negative by the simple H pylori stool antigen cassette test. The sensitivity, specificity, positive and negative predictive values were 33%, 86%, 83% and 38%, respectively. Compared to the gold standard methods, the simple H pylori stool antigen cassette test results were significantly different （P = 0.012）. CONCLUSION： Rapid STRIP!HpSA test could be used as a routine diagnostic tool in the microbiology laboratory for assessing clinical significance and eradication control of H pylori in upper gastrointestinal system bleeding patients.

Detection of H.pylori Antigen in the Stool Samples of Children,in Tekirdag,Turkey

Introduction: Helicobacter pylori (H. pylori) is an important bacterial pathogen, predominantly in undeveloped countries and regions. We conducted this study to investigate the presence of H. pylori antigen in the stool specimens of children, in Tekirdag, Turkey. Material and Methods: Stool specimens of 1441 children aging between 0 month to 15 years, with the complaints of abdominal pain, anemia, gastroenteritis, nausea and vomiting were included in the study. The subjects were divided into three groups based on their ages: Group A (0 month - 5 years), Group B (6 - 10 years) and Group C (11 - 15 years). All specimens were tested for H. pylori antigen with HP Ag (DIA.PRO, Diagnostic Bioprobes, Italy). Results were evaluated statistically. Results: The median age of children with H. pylori positive samples was 6.6 ± 4.1 and 47.9% were girls. Overall positivity of H. pylori stool antigen was 6.6%. Positivity rates due to ages in Groups A, B and C were: 8.9%, 5.8%,? 5.2% respectively (x2 = 9.3, p = 0.01). No difference was observed due to gender (x2 = 0.17, p = 0.68). Conclusion: Higher antigen positivity obtained in 0 - 5 years group, indicates the risk of acquiring the infection in early years of life. Preventive measures for the development of H. pylori infection gain importance, especially in developing countries.

Frequencies of the expression of main protein antigens from Helicobacter pylori isolates and production of specific serum antibodies in infected patients

AIM: To investigate the frequencies of the expression of main protein antigens of Helicobacter pylori (H py/ori) isolates, such as UreB, VacA, CagA1, HpaA, NapA, FlaA and FlaB and the production of specific antibodies in sera from H pylori-infected patients, and to understand the correlations among the different clinical types of chronic gastritis and peptic ulcer and the infection and virulence of H pylori. METHODS: H pylori strains in biopsy specimens from 157 patients with chronic gastritis and peptic ulcer were isolated and serum samples from the patients were also collected. The target recombinant proteins rUreB, rVacA, rCagAl, rHpaA, rNapA, rFlaA and rFlaB expressed by the prokaryotic expression systems constructed in our previous studies were collected through Ni-NTA affinity chromatography. Rabbit antisera against rUreB, rVacA, rCagAl, rHpaA, rNapA, rFlaA and rFlaB were prepared by using routine subcutaneous immunization. By using ultrasonic lysates of the isolates as coated antigens, and the self-prepared rabbit antisera as the first antibodies and commercial HRP-labeling sheep anti-rabbit IgG as the second antibody, expression frequencies of the seven antigens in the isolates were detected by ELISA. Another ELISA was established to detect antibodies against the seven antigens in sera of the patients by using the corresponding recombinant proteins as coated antigens, and the sera as the first antibody and HRP-labeling sheep anti-human IgG as the second antibody respectively. Correlations among the different clinical types of chronic gastritis and peptic ulcer and the infection and virulence of H pylori were statistically analysed. RESULTS: In the 125 isolates of H pylori, the positive rates of UreB, VacA, CagAl, HpaA, NapA, FlaA and FlaB were 100%, 65.6%, 92.8%, 100%, 93.6%, 100% and 99.2% respectively. In the 125 serum samples from the H pylori infected patients, the positive rates of antibodies against recombinant UreB, VacA, CagA1, HpaA, NapA, FIaA and FlaB were 100%, 42.4%, 89.6%, 81.6%, 93.6%, 98.4% and 92.8% respectively. H pylori strains were isolated from 79.6% (125/157) of the biopsy specimens, but no close correlations among the H pylori infection frequencies and different types of chronic gastritis and peptic ulcer could be found (P>0.05, x2 = 0.01-0.87). The VacA positive rate (82.40%) in the strains isolated from the specimens of patients with peptic ulcer and the anti-VacA positive rate (54.3%) in the sera from the patients were significantly higher than those (51.5%, 32.3%) from the patients with chronic gastritis (P<0.01, x2= 13.19; P<0.05, x2= 6.13). When analysis was performed in the different types of chronic gastritis, the VacA in the strains isolated from the specimems of patients with active gastritis showed a higher expression frequency (90.0%) than those from superficial (47.9%) and atrophic gastritis (30.0%) (P<0.05, x2 = 5.93; P<0.01,x2 = 7.50). While analysis was carried out in the strains isolated from the specimens with superficial (93.8%) and active gastritis (100%), NapA showed a higher expression frequency compared to that from atrophic gastritis (60.0%) (P<0.01, x2 = 8.88; P<0.05, X2=5.00). CONCLUSION: The types of chronic gastritis and peptic ulcer and their severity are not associated with H pylori infection frequency but closely related to the infection frequency of different virulent H pylori strains. The optimal antigens for developing vaccine and diagnostic kit are UreB, FlaA, HpaA, FlaB, NapA and CagAl, but not VacA.

Retrospective analysis of discordant results between histology and other clinical diagnostic tests on helicobacter pylori infection

BACKGROUND A reliable test is essential for diagnosing Helicobacter pylori(H.pylori)infection,and crucial for managing H.pylori-related diseases.Serving as an excellent method for detecting H.pylori infection,histologic examination is a test that clinicians heavily rely on,especially when complemented with immunohistochemistry(IHC).Additionally,other diagnostic tests for H.pylori,such as the rapid urease test(CLO test)and stool antigen test(SA),are also highly sensitive and specific.Typically,the results of histology and other tests align with each other.However,on rare occasions,discrepancy between histopathology and other H.pylori diagnostic tests occurs.AIM To investigate the discordance between histology and other H.pylori tests,the underlying causes,and the impact on clinical management.METHODS Pathology reports of gastric biopsies were retrieved spanning August 2013 and July 2018.Reports were included in the study only if there were other H.pylori tests within seven days of the biopsy.These additional tests include CLO test,SA,and H.pylori culture.Concordance between histopathology and other tests was determined based on the consistency of results.In instances where histology results were negative while other tests were positive,the slides were retrieved for re-assessment,and the clinical chart was reviewed.RESULTS Of 1396 pathology reports were identified,each accompanied by one additional H.pylori test.The concordance rates in detecting H.pylori infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments.117 discrepant cases were identified.Only 20 cases(9 with CLO test and 11 with SA)had negative biopsy but positive results in other tests.Four cases initially stained with Warthin-Starry turned out to be positive for H.pylori with subsequent IHC staining.Among the remaining 16 true discrepant cases,10 patients were on proton pump inhibitors before the biopsy and/or other tests.Most patients underwent treatment,except for two who were untreated,and two patients who were lost to follow-up.CONCLUSION There are rare discrepant cases with negative biopsy but positive in SA or CLO test.Various factors may contribute to this inconsistency.Most patients in such cases had undergone treatment.

Helicobacter pylori infection- recent developments in diagnosis

Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication therapy.Only highly accurate tests should be used in clinical practice,and the sensitivity and specificity of an adequate test should exceed 90%.The choice of tests should take into account clinical circumstances,the likelihood ratio of positive and negative tests,the cost-effectiveness of the testing strategy and the availability of the tests.This review concerns some of the most recent developments in diagnostic methods of H.pylori infection,namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H.pylori infection,such as magnifying endoscopy techniques and chromoendoscopy.In addition,the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups.Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test.Bacterial culture from the gastric biopsy is the gold standard technique,and is recommended for antibiotic susceptibility test.Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available,while molecular methods have gained attention mostly for detecting antibiotic resistance.

Five methods for detection of Helicobacter pylori in the Turkish population

AIM: To compare culture analysis, Helicobacter pylori (H. pylori) stool antigen (HpSA) test, polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH) for H. pylori detection. METHODS: One hundred and thirty-two consecutive adult dyspeptic patients receiving diagnostic endoscopy at the department of gastroenterology were enrolled in this study. Culture and histological examination were performed on biopsy specimens. PCR and FISH tests were applied to histopathological samples. Stool samples that were simultaneously collected were tested for the H. pylori antigen using the HpSA test and bacterial DNA using stool PCR. RESULTS: H. pylori was positively identified by histo-logical examination in 85/132 (64.4%) of the patients, while positive samples were found in 56 (42.4%), 64 (48.5%), 98 (74.2%), 28 (21.2%) and 81 (61.4%) of the patients by culture, HpSA, PCR, stool PCR and FISH methods, respectively. The results of the culture, biopsy PCR, HpSA and FISH tests, with the exception of the stool PCR, were found to correlate with the histological examination as a gold standard. CONCLUSION: The HpSA test is a rapid, simple, and noninvasive test for monitoring therapy. FISH is an accurate, rapid, cost-effective, and easy-to-use test for H. pylori detection.

Correlation of Endoscopic Findings with Various <i>Helicobacter pylori</i>Tests among Dyspeptic Patients

Background: Helicobacter pylori is the most common chronic bacterial infection, and a significant etiological factor in acid peptic diseases and gastric cancer. Dyspepsia is a common gastrointestinal disorder, and the most common indication for gastroscopy. Detection of H. pylori during endoscopy has become standard clinical practice. Elevated levels of inflammatory markers such as C-reactive protein (CRP), are associated with pathological changes, and hence give useful information for exact diagnosis and therapy. Objectives: To determine the relationship between endoscopic findings, highly sensitive C-reactive protein level (hs-CRP) and H. pylori infection among dyspeptic patients using serological tests, stool antigen for H. pylori and antral histology. Methods: This was a prospective study;patients with dyspepsia, who referred to Kurdistan Teaching Center of Gastroenterology & Hepatology in Sulaimani City were assessed, during the period of December 2012 to March 2014. They underwent gastroscopy, and biopsies were taken from the corpus and antral portions of antral portion for histopathological exam. Patients’ serum samples were tested for H. pylori infection using ELISA method to detect (IgG & IgA) anti-bodies and stool samples were examined using rapid immunoassay method to detect H. pylori antigens. hs-CRP was assessed using ELISA. Results: One hundred dyspeptic patients were included in the study. The mean age was 34.2 years and male comprised 54% of the study samples. The common findings in oesophagogastroduodenoscopy (OGD) examination were antral gastropathy (59%) and duodenal ulcer (21%). A statistically significant (P H. pylori IgG and IgA levels (titer). There was a highly significant (P H. pylori IgG and the endoscopic findings. The highest serum level of H. pylori IgG was found in duodenal ulcer and antral gastritis, (88.86 ± 42.0) and (70.05 ± 35.2) Au/ml, respectively. There was a highly significant correlation (P H. pylori positive antral biopsy, in duodenal ulcer, antral gastritis and duodenitis was 100%, 94.9% and 75% respectively. Also duodenal ulcer and antral gastritis showed high mean and percentage but no significant differences in both H. pylori IgA and stool Antigen.

胃癌患者Hp感染及血清GPDA活性的变化

目的探讨胃癌患者粪便Hp检出率与血清GPDA活性变化的关系。方法利用幽门螺旋杆菌粪便抗原检测法(HpSA法)和速率法分别检测117例初治前胃癌患者、45例良性胃部疾病患者及40例正常人粪便中的Hp阳性率和血清GPDA活性并作相关分析。结果胃癌患者Hp感染率及其血清GPDA的阳性率分别为70.1%和71.5%,显著高于良性胃部疾病患者和正常人(P<0.01)。胃癌的部位与Hp感染有关(P<0.05),而其血清GPDA活性与临床各因素的关系并不密切(P>0.05),两者无相关性(P>0.01)。结论Hp感染可能与胃癌的发生、发展有关,血清GPDA检测对胃癌的诊断有一定的意义。

HpSA快速试纸在检测幽门螺杆菌粪便抗原中的应用价值

目的评价幽门螺杆菌粪便抗原(HpSA)快速试纸在检测Hp粪便抗原的敏感性和特异性。方法以13C-尿素呼气试验(13C-UBT)和(或)快速尿素酶结果为金标准,对有上消化道症状患者的粪便进行HpSA快速试纸检测,其中62例为抗Hp治疗之前患者(治疗前组),42例为抗Hp治疗之后的复查患者(治疗后组)。结果治疗前组患者按“金标准”诊断Hp感染阳性24例,阴性38例,HpSA检测阳性27例,阴性35例,其敏感性和特异性分别为100%和92%;治疗后组患者按“金标准”诊断Hp感染阳性15例,阴性27例,HpSA检测阳性19例,阴性23例,其敏感性和特异性分别为93%和81%;104例患者总敏感性和特异性分别为97%和88%。结论HpSA快速试纸在临床上诊断Hp现症感染和判断抗Hp疗效方面均有很好的敏感性和特异性。

HpSA试验监测幽门螺杆菌感染根除效果的价值

目的检测粪便幽门螺杆菌抗原(HpSA)水平在根除治疗期间及以后的变化,并评估根除治疗疗效检测的最佳时间。方法受试者为57例Hp阳性的病人,均接受了一周的三联疗法。根除治疗的结果由尿素呼气试验、细菌培养以及治疗结束后6周时的组织检查来判定。HpSA的水平则从治疗前到治疗后的12周,先后共检测9次。结果根除治疗获得成功组病人的HpSA在治疗结束后立即转阴并保持阴性。而治疗失败组的病人HpSA也在治疗结束后立即转阴,但在治疗结束后2周时又转为阳性。治疗失败组在根除治疗开始后第4天HpSA试验的平均吸收值显著高于根治成功组。HpSA试验诊断(根除成功与否)的准确率在治疗2周以后增长到>90%。治疗结束后第2、6、8、12周HpSA的诊断准确率与治疗结束后第4周相比无显著差异。结论根除成功组病人的HpSA水平在治疗后的变化情况同失败组显著不同。HpSA的检测对于评估根治疗效是非常有意义的,且评估治疗效果的适当时机是在根除治疗后2周以后。

粪便Hp抗原在成人与儿童幽门螺杆菌现症感染中的临床应用

目的进行粪便幽门螺杆菌(Hp)抗原检测诊断,上消化道症状成人与儿童患者的幽门螺杆菌现症感染情况.方法上消化道症状患者120例,成年和儿童各60例,采用幽门螺杆菌粪便抗原(HpSA)免疫快检卡诊断幽门螺杆菌现症感染.结果上消化道症状患者成年组、儿童组幽门螺杆菌现症感染率分别为38.3%(23/60)、18.3%(11/60).两组人群幽门螺杆菌现症感染率差异有统计学意义(P<0.05).结论Hp粪便抗原检测作为非侵入性Hp现症感染的诊断方法,具有简便、易行、易重复的特点.

HpSA免疫快检卡检测幽门螺杆菌粪便抗原的临床价值

目的 评价HpSA免疫快检卡检测Hp粪便抗原诊断Hp感染的可靠性。方法 收集 5 3例接受胃镜检查患者的粪便标本 ,用HpSA免疫快检卡检测HpSA ;以尿素酶试验、组织学染色和培养检测Hp作为“金标准” ,其中两项试验阳性定为Hp感染。结果 HpSA免疫快检卡检测诊断Hp感染的敏感性为 92 6 % (2 5 / 2 7) ,特异性为 88 5 % (2 3/ 2 6 ) ,阳性预测值为 89 3% (2 5 /2 8) ,阴性预测值为 92 % (2 3/ 2 5 ) ,总的检测准确性为 90 6 % (4 8/ 5 3)。结论 HpSA免疫快检卡是一种准确。

健康体检人群Hp感染实验室诊断及血清抗体谱分析

目的了解健康体检人群幽门螺杆菌(Hp)感染情况,探讨Hp抗原与抗体检测在实验室诊断中的应用价值及揭示体检人群中Hp感染的血清抗体谱分布特征。方法对2017年1月至12月来本院体检的596例体检者,采用14C-尿素呼气试验(14C-UBT)、粪便Hp抗原及血清Hp抗体胶体金试验三种方法进行Hp检测;另对Hp抗体检测阳性的体检者进行抗体谱检测;严格执行样本入选原则,按照体检者年龄、性别进行分组统计。结果幽门螺杆菌14C-UBT实验、粪便Hp抗原以及血清Hp抗体检测,三者之间的检测结果差异无统计学意义(P>0.05);体检人群中采用Hp粪便抗原与血清Hp抗体联合检测,发现两者分布的特征与Hp感染疾病的进程(现症感染、既往感染和感染初期)存在关联性,其中粪便Hp抗原与血清Hp抗体两者阳性的受检者占总Hp感染者中比重最大(现症感染,36.74%);男女间Hp感染差异无统计学意义(P>0.05);按照不同年龄进行分组调查发现Hp感染率随着年龄增加呈上升趋势(P<0.05),且Hp总感染率为39.09%(223/596);不同血清型分布具有明显特征:在不同年龄呈现先上升后下降的趋势,其中31~40,41~50,51~60三个年龄组的Ⅰ型血清型的阳性率较高(72.06%~76.78%),而年龄组<21和>60岁组的Ⅰ型阳性率相对下降,分别为53.85%和53.33%,另外血清抗体谱中以UreA-66KD(98.68%)和UreB-30KD(97.80%)抗体阳性率最高,而其他三个蛋白抗体CagA-116KD、VacA-95KD、VacA-91KD阳性率相对较低,分别为72.24%、70.93%、68.72%。结论粪便Hp抗原与血清Hp抗体联合检测更适用于健康体检筛查工作,另外本文对于Hp感染的血清学调查积累了Hp感染的流行病学资料,为进一步研究Hp感染疾病的发生、发展以及治疗奠定了理论基础。

联合胃蛋白酶原、胃泌素、粪便Hp抗原检测对萎缩性胃炎和胃癌的诊断价值

目的:探索胃蛋白酶原(PG)、胃泌素及粪便幽门螺杆菌抗原(Hp SA)在萎缩性胃炎及胃癌中的诊断价值。方法:使用酶联免疫吸附法检测萎缩性胃炎及胃癌患者血清中PGⅠ、PGⅡ及胃泌素-17(G-17)水平,并计算PGR(PGⅠ/PGⅡ)值;采用受试者工作特征曲线(ROC曲线)分析各指标的诊断价值;使用免疫胶体金法检测Hp SA的阳性率。结果:萎缩性胃炎组和胃癌组较对照组的PGⅠ水平和PGR值下降,G-17水平上升,Hp SA阳性率增高,差异均具有统计学意义。PGⅠ、PGR及G-17具有诊断萎缩性胃炎和胃癌的价值。联合PGⅠ、PGR、G-17和Hp SA检测对萎缩性胃炎和胃癌的诊断评估效果最佳。结论:联合检测PG、G-17和Hp SA可有效诊断萎缩性胃炎和胃癌。

ROC曲线评价HpSA诊断幽门螺杆菌现症感染价值

目的:应用受试者工作特征(receiver operating characteristic,ROC)曲线分析评价幽门螺杆菌(helicobacterpylori,Hp)粪便抗原(helicobacter pylori stool antigen,HpSA)对幽门螺杆菌现症感染的诊断价值。方法:以组织切片染色法及快速尿素酶法(rapid urease test,RUT)联合检测结果作为Hp现症感染诊断"金标准",通过对HpSA的检测,采用ROC评价HpSA的诊断效能。结果:"金标准"阳性组HpSA检测光密度值[0.44(0.06～1.23)]明显高于阴性组[0.08(0.03～0.23)](P<0.05)。ROC曲线下面积为(0.967±0.019),当确定诊断界值为0.15时,HpSA检测Hp现症感染敏感性、特异性、准确性及阴性预测值、阳性预测值分别为92.9%、90.5%、92.2%、82.6%及96.3%。结论:HpSA检测简便、无创,是反映Hp现症感染较理想的方法。

基于粪便样本检测幽门螺杆菌感染及耐药情况的研究进展

幽门螺杆菌(Helicobacter pylori,H.pylori)是一种革兰氏阴性细菌,特异性定植于人类的胃上皮,特别是胃窦上皮中。它是慢性胃炎、消化性溃疡、胃癌、胃黏膜相关淋巴组织淋巴瘤及一些胃外疾病的主要病因。由于H.pylori抗生素耐药菌株的迅速出现,其根治率正逐年下降。对抗生素耐药性进行检测,指导临床医师选择治疗方案是目前提高H.pylori根治率的重要手段。目前,H.pylori抗生素耐药性的检测主要是患者基于接受内镜检查的侵入性检测。而针对非侵入性手段获得粪便样本的检测相比于侵入性检测具有无创便捷、高效、依从性好等优点。近年来针对粪便样本进行抗原检测、分子检测等多种方式的研究均有报道。本文就基于粪便样本诊断H.pylori感染及检测其耐药情况的研究进展进行综述和分析,为探索更为便捷、高效的诊断方式和指导治疗手段提供思考。

体检人群幽门螺杆菌感染检测意愿调查

目的探讨体检人群对H.pylori感染检测的主动性及其对检测方式的倾向性。方法于2022年9月至2022年12月在国内两家综合性三甲医院的体检人员中发放电子调查问卷,问卷内容包括受访者对H.pylori感染及检测方式的了解情况,主动给自己及家中老人、儿童(<14岁)检测的意愿,及其对尿素呼气试验(urea breath test,UBT)和H.pylori粪便抗原试验(H.pylori stool antigen test,HpSAT)的比较与选择等。结果共回收488份有效问卷。消化道症状或疾病在体检人群(57.0%)及其家庭成员(35.5%)中普遍存在。体检人群对H.pylori感染的熟悉率仅为11.9%。43.0%受访者会在体检时主动检测,36.9%的受访者在医师建议下才会进行检测,而20.1%不会主动检测。影响检测主动性的因素主要是对H.pylori感染的了解程度。对于家中老人和儿童的检测,大部分体检人员需要医师建议才会进行检测。体检人员选择检测方式时,主要看其重准确性、方便性、安全性,超过80%体检人员会选择UBT。结论体检人群对H.pylori感染的认知水平较低,但检测意愿性较强,在检测时倾向于选择传统的UBT,对新兴的快速HpSAT缺乏了解。

粪便幽门螺杆菌抗原检测对儿童复发性腹痛病因诊断的价值

目的慢性胃炎、消化性溃疡是引起儿童复发性腹痛(recurrent abdom inalpain,RAP)的主要原因之一,而幽门螺杆菌(helicobacterpylori,Hp)感染与慢性胃炎、消化性溃疡的相关性尚有待进一步探讨。目前国内儿科临床上缺乏一种简便、安全、经济、有效地非侵入性Hp感染检测方法。故此,该研究探讨RAP与Hp感染的关系及幽门螺杆菌粪便抗原检测(Hpstoolantigen,HpSA)在RAP病因诊断中的价值。方法对182例RAP患儿进行13C尿素呼气试验(13Cureabreathtest,13CUBT)及HpSA检测,测定其Hp感染率,观察抗Hp治疗后RAP患儿的腹痛缓解率,并对两种检测方法进行比较。结果RAP儿童Hp感染率为41.2%。男女比例为1∶1.143,差异无显著性。Hp阳性儿童进行抗Hp治疗后,Hp根除和未根除的患儿腹痛缓解率分别为93.4%及28.6%。两者比较差异有显著性(P<0.05)。以13CUBT作为金标准计算,HpSA检测方法的敏感性、特异性、假阳性率、假阴性率、准确率、阳性预测值、阴性预测值分别为90.7%,97.2%,2.8%,9.3%,94.5%,95.8%,93.7%。HpSA试验与13CUBT一致性用Kappa值表示为0.886,U=25.237,P=0,两者有高度一致性。结论Hp感染与RAP有密切相关性,可能为RAP的主要致病因素;HpSA检测有较高的敏感性和特异性,还具有安全、简便可靠、经济、非侵入性等优点,在RAP病因诊断中具有良好的实用价值。