唾液抗幽门螺杆菌抗体的检测

唾液抗幽门螺杆菌抗体的检测朱人敏路又可王琳幽门螺杆菌（Ｈｐ）感染与慢性胃炎、消化性溃疡及胃癌的关系极为密切，与之相关的非侵入性检查方法一直受到重视。近年来，唾液标本中抗Ｈｐ抗体的检测已引起关注［１］。我们对上消化道疾病患者血清和唾液抗ＨｐＩｇＧ和Ｉｇ...     

唾液抗幽门螺杆菌IgG检测诊断幽门螺杆菌感染的评价

目的 评价唾液抗幽门螺杆菌（ＨＰ）抗体诊断ＨＰ感染的价值。方法 ９３例病人同时进行唾液抗ＨｐＩｇＡ测定、快速尿素酶试验（ＲＵＴ）、组织涂片ＨＥ染色及病理ＷＳ银染色法诊断ＨＰ感染结果 唾液抗ＨｐＩｇＧ检测阳性率近似于ＲＵＴ法，高于组织涂片ＨＥ染色法和病理ＷＳ银染色法，其诊断ＨＰ感染的敏感性与９６．９７％，特异性８８．２３％，准确性９５．１８％，阳性预测值９７％，阴性预测值８８．２４％，结论唾液抗Ｈｐ     

唾液,血清抗幽门螺杆菌抗体检测结果的比较

目的：比较同一人群唾液与血清抗幽门螺杆菌（Hp）抗体水平的差异，探讨唾液抗Hp抗体检测的临床意义．方法：应用ELISA方法平行检测59例上消化道疾病患者血清和唾液抗HpIgG和IgA。结果：四种检测方法诊断Hp感染的准确性排序为：血清抗HpIgG96．61％，唾液抗HPIgG94．92％，血清抗HpIgA86．44％，唾液抗HpIgA81．36％．结论：唾液抗HpIgG是一个诊断Hp感染的敏感、特异指标。     

在唾液中检测幽门螺杆菌的意义

探讨一种有效的非侵入性幽门螺杆菌诊断方法。方法１３８／１５９例各类型胃、十二指肠疾病患者的唾液和胃黏膜,用空泡毒素基因为模板设计的引物行聚合酶链反应,其产物行单链构象多态性分析和Ｓｏｕｔｈｅｒｎ杂交。     

尿液、唾液与血清抗幽门螺杆菌抗体检测的比较

自从幽门螺杆菌 (Ｈｐ)分离成功以来 ,围绕这种病原体检测的新技术和新方法层出不穷[1] 。采集体液标本检测抗ＨｐＩｇＧ ,其中最为方便的当属尿液。为此 ,我们设计了一项前瞻性研究 ,对检测尿液抗ＨｐＩｇＧ的实际临床诊断价值作一评价。一、材料与方法1.检测对象 :　在我科门诊和住院患者中随机选择 10 2例 ,男 73例 ,女 2 9例 ,年龄 14～ 6 3岁 (平均 4 2岁 )。所有病例均接受胃镜检查 ,胃窦活检 ,分别作快速尿素酶试验(ＲＵＴ)、Ｈｐ选择性分离培养 ,切片行组织病理与Ｈｐ检查。入选病例必须为 3个月内未接受根除Ｈｐ治疗者 ,在胃镜检查…     

末梢血快速测定幽门螺杆菌IgG抗体

目前用于Ｈｐ诊断的方法很多，如创伤性的有快速尿素酶试验（ＲＵＴ）、组织病理切片染色、分离培养、聚合酶链反应（ＰＣＲ）及其相关技术．非创伤性的有血清学、尿素呼气试验．下面是我院引用美国Ｂｉｏａｇｅ公司原料加工制成非创伤性的采用末梢血（４０μＬ）快速检测幽门螺杆ＨｐＩｇＧ抗体．１　材料和方法１．１　材料　１９９８０４／１０因上消化道症状来我院胃肠门诊就诊，并行内镜检查的胃炎或消化性溃疡患者１５０例，其中男１０２例，年龄１７岁～７７岁，平均４７岁．女４８例，年龄２１岁～７６岁，平均４９岁．全部病例…     

PCR检测唾液中幽门螺杆菌的研究

Ｈｐ与胃炎、胃溃疡甚至胃肿瘤等的发病关系密切,国际癌研究协会已于１９９４年将Ｈｐ列为人的Ⅰ类致癌因子。从唾液中直接检测Ｈｐ无创、简便,但现有ＰＣＲ法对唾液中Ｈｐ检测方法繁琐且阳性率低［１］。本文在原实验基础上,经过重新设计引物,反复多次对ＤＮＡ抽提方...     

ELISA对幽门螺杆菌感染血清IgG,IgA,IgM抗体检测的诊断价值

应用酶联免疫吸附试验（ＥＬＩＳＡ）对无选择性作内镜检查的９０例患者血清，分别作抗ＨＰＩｇＧ，ＩｇＡ，ＩｇＭ特异性抗体的检测，同时与胃粘膜活检组织块的镜检，培养，快速尿素酶试验的结果进行比较。ＥＬＩＳＡ检测结果显示血清ＩｇＧ，ＩｇＡ，ＩｇＭ抗体的阳性率分虽为７１．１％（６４／９０），５６．６％（５１／９０），５６．６％（５１／９０），ＩｇＧ检出率均高于检法６５．６％％（５９／９０），尿素酶试验５５．     

口腔幽门螺杆菌和胃内幽门螺杆菌感染的关系

幽门螺杆菌(H．pylori)与上胃肠道疾病密切相关，口腔为上消化道入口，有学者提出口腔中亦有H．pylori的生存，并认为口腔H．pylori感染和胃H．pylori感染之间存在一定的相关关系，口腔H．pylori感染可能是胃内H．pylori根除治疗后复发的一个潜在的再感染源。     

尿液、唾液与血清抗幽门螺杆菌抗体检测的比较

目的：比较尿液、唾液与血清抗幽门螺杆菌（Hp）抗体检测的临床应用价值。方法：应用酶标记免疫吸附测定技术检测102例患尿液、唾液和血清抗Hp IgG，根据快速尿素酶试验，Hp选择性分离培养和组织切片H－E染色确定其Hp感染状态。结果：尿液、唾液和血清三种诊断方法的敏感性、特异性、准确性分别为：96．7％、87．1％、93．5％；93．5％、83．9％、90．3％与95．2％、93．5％、94．5％。结论：以上三种诊断方法依据准确性评优排序，应为：血清方法＞尿液方法＞唾液方法；检测尿抗Hp IgG方法因其准确、简便、易行，应用于流行病学调查尤为可取。     

粪便抗原检测诊断幽门螺杆菌现症感染

目的 评价应用免疫酶联吸附试验(ELISA)检测粪便中幽门螺杆菌(Helicobacter pylori)抗原诊断H.pylori现症感染的敏感性和特异性。方法 应用^14C呼气试验以及幽门螺杆菌粪便抗原(HpSA)试验，对100例因上消化道不适就诊，怀疑有H.pylori感染的患者进行检测，观察两种检查的符合率。结果 ^14C呼气试验和HpSA同时阳性者38例，^14C呼气试验阳性而HpSA阴性者4例；^14C呼气试验和HpSA同时阴性者57例，^14C呼气试验阴性而HpSA阳性1例。以^14C呼气试验作为金标准计算，HpSA检测方法的敏感性为90．48％，特异性为98．28％。结论 幽门螺杆菌抗粪便原检测与^14C呼气试验有较高的符合率，而且简便易行，不需特殊设备，解决了无法进行呼气试验的婴幼儿和有肺部疾患者的非侵人性幽门螺杆菌现症感染诊断问题，是一种非侵入性幽门螺杆菌现症感染诊断的新方法。     

The best method of detecting prior Helicobacter pylori infection

AIM: Prior Helicobacter pylori (H pylori) infection has often been underestimated. These underestimations have misled physicians attempting to determine the significance between H pylori and certain gastrointestinal lesions such as intestinal metaplasia, atrophic gastritis, and gastric cancer. Our study endeavored to detect past H pylori infections accurately, easily,and rapidly with the newly developed immunoblot kit, Helico Blot 2.1.METHODS: Thirty-three patients, including 25 H pylori infected and 8 uninfected cases, were enrolled in our study. All patients received consecutive gastroendoscopic examinations and 13C-urea breath test (UBT) tests at 6-or 12-mo intervals for up to 4 years. Serum samples were obtained from each patient at the same time. Intragastric H pylori infection was confirmed in accordance with the gold standard. Twenty-five H pylori-infected patients received triple therapies after initial bacterial confirmation,and were successful in eradicating their infections. Serially obtained sera were tested by means of Helico Blot 2.1.RESULTS: Current infection marker detected by Helico Blot 2.1 was unreliable for representing ongoing H pylori infection. Only 35 and 37 ku antibodies of H pylori had significant seroconversion rates 1 year after having been cured. The seropositive rates of 116 ku (cytotoxin-associated antigen [CagA]) and Helico Blot 2.1 were nearly 100%during 4-year follow-up period. Both CagA antigen and Helico blot 2.1 could serve as indicators of long-term H pylori infection.CONCLUSION: Helico Blot 2.1 can detect past H pylori infections for up to 4 years, and is the best method to date for detecting previous long-term H pylori infection.     

Helicobacter pylori infection in subjects negative for high titer serum antibody

AIM To investigate the clinicopathological features of the patients testing negative for high titer serum antiHelicobacter pylori(H. pylori) antibody.METHODS The antibody titers were measured using antigens derived from Japanese individuals. ~(13)C-urea breath test-positive individuals were defined as having H. pylori infection. We investigated the demographic characteristics, laboratory data, endoscopic findings including Kyoto classification of gastritis, and histology in negative-high titer patients without H. pylori eradication therapy. Kyoto classification consisted of scores for gastric atrophy, intestinal metaplasia, enlarged folds, nodularity, and redness.RESULTS Of the 136 subjects enrolled, 23(17%) had H. pylori infection. Kyoto classification had an excellent area under the receiver operating characteristics curve(0.886, 95% confidence interval: 0.803-0.968, P = 3.7 × 10~(-20)) for predicting H. pylori infection with a cutoff value of 2. Further, Kyoto classification, H. pylori density, and neutrophil activity had high accuracies(89.7%, 96.3%, and 94.1%, respectively). Kyoto classification was independent of the demographic and laboratory parameters in multivariate analysis.CONCLUSION Endoscopic Kyoto classification of gastritis is a useful predictor of H. pylori infection in negative-high titer antibody patients.     

幽门螺杆菌感染可视化诊断的临床研究

目的改革国外对幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ，Ｈｐ）感染可视化诊断中的繁杂方法。方法对３００例经胃镜检查病例，在胃镜直视下采用喷洒ｐＨ５．５的调节水来调整胃黏膜表面的ｐＨ值，再对胃黏膜表面直接喷洒０．５ｍｏｌ／Ｌ尿素０．１％酚红溶液。通过酚红的变红反应，使Ｈｐ的感染及其分布可视化。并对尿素酚红液变色呈阳性反应的病例，在变色部位取活检，对呈阴性反应的不变色病例，在胃窦近幽门２ｃｍ左右的前、后壁、胃窦前庭或胃体大弯分别取活检２～３块，进行病理组织切片的Ｇｉｅｍｓａ染色检查并将两者相对照。结果３００例中１９０例胃镜喷洒尿素酚红溶液后胃黏膜表面变红呈阳性反应，病理检查Ｈｐ呈阳性者１８２例，诊断符合率为９５．８％（１８２／１９０）。１１０例呈阴性反应病例，病理检查Ｈｐ呈阴性者９５例，两者符合率为８６．４％（９５／１１０）。镜下诊断与病理诊断总符合率为９２．３％（２７７／３００）。结论对Ｈｐ感染的可视化诊断，改良的尿素酚红液喷洒为一种简单可行的内镜下诊断方法。     

儿童幽门螺杆菌感染的诊断和治疗

幽门螺杆菌（H．pylori）感染主要发生在儿童期，儿童期许多消化系统疾病，如慢性胃炎、消化性溃疡等与H．pylori感染密切相关，并可能与成年后胃癌的发生相关。H．pylori感染还可导致儿童缺铁性贫血。H．pylori感染主要经“口-口”或“粪-口”以及“胃-口”途径从人到人传播，社会经济因素对H．pylori感染的影响是主要的。胃镜活检胃黏膜细菌学检查是诊断H．pylori现症感染的“金标准”，粪抗原的测定和^13C-尿素呼气试验可用于诊断和评价疗效。质子泵抑制剂（PPI）加两种抗生素的三联疗法是目前最佳治疗方案，抗生素耐药的不断增加给治疗带来了困难．儿童H．pylori感染对大环内酯类药物的耐药高于成人。     

口腔幽门螺杆菌感染与胃幽门螺杆菌感染的相关性探讨

目的 分析口腔和胃幽门螺杆菌(Hp)感染的检测结果,探讨口腔Hp感染与胃Hp感染的相关性,及口腔Hp感染对Hp根除治疗的影响.方法 采用唾液测定螺旋杆菌抗原技术(HPS)和13C/14C尿素呼气试验(UBT)同步检测的方法,对114例有上消化道症状的初诊患者(第1组),129例确诊为胃Hp感染经根除治疗后4周复查的患者(第2组)和33例无消化道症状的健康志愿者(第3组),进行口腔和胃Hp检测.结果 第1组、第2组和第3组HPS阳性检出率分别为77.19%、75.97%和81.82%,3组比较差异无统计学意义(χ2=0.47,P值均>0.05);UBT阳性检出率第1组(52.63%)比第2组(34.11%)和第3组(21.21%)高,第1组与第2组和第3组比较,差异有统计学意义(χ2=8.48和10.19,P均<0.05),第2组与第3组之间差异无统计学意义(χ2=2.03,P>0.05);在UBT阳性者中,HPS阳性检出率差异无统计学意义(3组分别为81.67%、88.64%和100%,χ2=2.25,P值均>0.05).结论 唾液中存在高Hp抗原检出现象,口腔可能是Hp在胃以外的"第二定居地".口服药物治疗对口腔Hp感染几乎无效,口腔Hp的存在可能是胃病发病和复发的一个重要和直接的原因.

Abstract：

Objective To explore association between Helicobacter pylori (Hp) infection in oral cavity and gastric Hp infection through oral cavity and gastric Hp infection testing results analysis, and also to study the effect of Hp infection in oral cavity on Hp eradication treatment. Methods Through Hp saliva test (HPS) and 13C/14C urea breath test (UBT) method, the Hp in oral cavity and stomach were tested in 114 first-visit patients with upper gastrointestinal symptoms (group 1), 129 re-visiting patients who were diagnosed gastric Hp infection with eradication treatment for four weeks (group 2) and 33 volunteers without gastrointestinal symptoms. Results The positive rates of Hp infection by HPS method were 77.19%, 75.97% and 81.82% in group 1, group 2 and group 3 respectively. There was no significant difference between these three groups (χ2=0.47, P>0.05). The positive rate of Hp infection by UBT method in group 1 (52.63%) was higher than those of group 2 (34.11%) and group 3 (21.21%). Compared group 1 with group 2 or group 3, there was significant difference (χ2=8.848, 10.19, P<0.05). There was no significant difference between group 2 and 3 (χ2=2.03, P>0.05). In positive individuals of these three groups tested by UBT method, there was no significant difference of positive rate tested by HPS method (81.67%, 88.64% and 100% of three groups respectively, χ2=2.25, P>0.05). Conclusions The High detection of Hp antigen in saliva indicates that the oral cavity may be the "second settlement" of Hp beside stomach. The oral medicine haslittle effect on oral cavity Hp infection. The existence of oral Hp may be an important and direct factor of incidence and recurrent of gastric diseases.     

幽门螺杆菌粪便抗原检测在幽门螺杆菌感染诊断及随访中的价值

目的 对幽门螺杆菌粪便抗原（HpSA）检测诊断hp感染、hp根除治疗后的随访及在儿童中的应用价值,进行临床评价。方法 以快速尿素酶试验=、组织学和细菌培养中的二项阳性或细菌培养一项阳性作为诊断HP的金标准,采用ELISA法检测128例因上消化道症状接受胃镜检查患者HPSA,评价HPSA诊断HP感染的敏感性、特异性;其中79例同时进行^13C-UBT作为对照,评价HPSA诊断HP感染的准确性。结果 在128例中,HPSA检测的敏感性、特异性和准确性分别为95.16%,98.41%和96.80%。根除治疗前HPSA检测和^13C-UBT诊断HP的敏感性为97.96%和95.92%,特异性为96.67%和100.00%,准确性均为97.46%;根除治疗后4周随访HPSA检测和^13C-UBT的敏感性均为100.00%,特异性为91.43%和94.29%,准确性 93.18%和95.45%。以^13C-UBT作标准,HPSA检测29例患儿HP感染敏感性、特异性和准确性分别为91.67%,88.23%和89.66%。结论 HPSA检测是一种简便、准确、非侵入性的诊断HP感染的方法,适用于HP感染的诊断、根除治疗后随访及儿童患者。