14C-尿素呼气试验对幽门螺杆菌感染的诊断价值

目的：评估^14C-尿素呼气试验（^14C-UBT）对幽门螺杆菌（HP）感染的诊断价值。方法：对2000例1月内未曾使用可能影响HP检测结果的药物者同步完成快速尿酶试验（RUT）、病理、^14C-UBT检测，以病理（HE染色）、RUT均阳性为诊断HP感染的标准，评价^14C-UBT对HP感染的诊断价值。结果：^14C-UBT的敏感性89.7％，特异性98.4％，阳性预测值98.4％，准确性93.4％，阴性预测值88.1％。结论：^14C-UBT是HP感染无创伤、敏感而特异的诊断方法。     

胃大部切除术后幽门螺杆菌感染分析

近2年,我们对14名接受胃大部切除术的患者检测Hp,并与14名消化性溃疡患者作对照,以探讨Hp感染与胃大部切除胃肠吻合方式及残胃病变之间的相关性。     

对幽门螺杆菌感染五种常用检查方法的评价

幽门螺杆菌（Ｈｐ）是一种生长在胃粘膜表面的致病菌,它可引起活动性胃炎和消化性溃疡直至胃癌,还有相当数量的Ｈｐ阳性者不发病。Ｈｐ感染的表现形式如此多种多样化,哪些感染者需要治疗存在分歧,对Ｈｐ的诊断标准也不一致。我们应用五种检查方法,对Ｈｐ阳性者综合分析,试图提供简便易行而又准确的Ｈｐ诊断方法组合及治疗适应证的指标。 １．病例选择和方法：门诊因上消化道症状而就诊的病人先后行Ｈｐ的５种方法检查,其中非侵人性检查包括１４Ｃ－尿素呼气试验（１４Ｃ－ＵＢＴ）、Ｈｐ细胞空泡毒素相关蛋白抗体（ＣａｇＡ抗体）和…     

老龄患者胆总管结石与幽门螺杆菌感染的关系

幽门螺杆菌（HP）是1种存在于胃黏膜的革兰氏阴性需氧菌,与多种疾病有关,包括胃肠道疾病、特发性血小板减少性紫癜、缺铁性贫血、冠状动脉粥样硬化性心脏病、痤疮、湿疹等”。1998年Flgum发现胆结石患者存在幽门螺杆菌感染,而且幽门螺杆菌可以使胆汁中的直接胆红素转变成为间接胆红素,间接胆红素与钙结合则形成胆结石。我们通过检测^14C呼气试验DPM值、血清及胆汁HP-IgG抗体,了解老龄胆总管结石患者中幽门螺杆菌的感染率。     

13C—尿素呼气试验诊断幽门螺杆菌感染的临床意义

对６５例胃、十二脂肠疾病患者和３６例健康人行１３Ｃ－尿素呼气试验（Ｃ－ＵＢＴ）、病理组织学和快速尿素酶（ＲＵＴ）三种方法检测幽门螺杆菌（ＨＰ）,其中任两项阳性者认为有ＨＰ感染。结果显示,Ｃ－ＣＢＴ、病理组织学和ＲＵＴ检测的阳性率分别为８１．５４％、８３．１％、８４．６２％;敏感性分别为９６．２３％、８６．８％、８４．９１％;特异性分别为１００％、９１．６７％、８３．３３％。认为Ｃ－ＵＢＴ和病理组织     

3种常用幽门螺杆菌感染检测方法的诊断价值及影响因素分析

胃镜直视下取胃黏膜作病理组织学检查及快速尿素酶试验(RUT)、14C(或13C)-尿素呼气试验(UBT)是目前应用较为广泛的检测幽门螺杆菌(Hp)感染的方法.3种方法各有其对Hp感染的诊断价值及影响结果的因素.我们通过对283例病例同步进行这3种方法检测进一步分析其诊断价值.     

胃大部切除术后幽门螺杆菌感染致吻合口溃疡的临床分析

目的 探讨胃大部份切除术后幽门螺杆菌（Hp）感染致吻合口溃疡的发生因素，为术后Hp感染和吻合口溃疡的防治提供依据。方法 对123例胃大部切除术后患者（36例职业司机组，其他患者87例患者对照组）进行胃镜检查、快速尿素酶试验及Hp免疫印迹检测，检查胃大部切除术后残胃病变、吻合口溃疡的发生情况、胃内Hp感染及Hp抗体，以了解幽门螺杆菌感染、宿主抗Hp免疫反应强度，免疫分型，Hp的菌型（尤其是CagA和VacA）和感染时间的长短，进一步研究Hp的致病作用。结果 司机组吻合口溃疡的发生率和Hp的检出率分别为47．2％和41．7％，而对照组为25．3％和21．8％。司机组吻合口溃疡的发生率和Hp感染率显著增高于对照组。结论 司机组胃大部切除术后吻合口溃疡的发生率和Hp感染率明显高于非司机组，提示胃大部切除术后Hp感染和工作紧张、饮食不规律对吻合口溃疡的发生起重要作用，术后行Hp根除治疗、避免精神紧张和饮食不节是降低吻合口溃疡发生率的重要措施。     

在诊断HP的^14C—UBT 中^14C—尿素的最低有效活度的研究

目的 诊断ＨＰ的＾１４Ｃ－ＵＢＴ具有无创、价廉、方便的优点，受到临床医生的普遍欢迎，但由于＾１４Ｃ是放射性核素，从安全笥考虑，用量越低越好，因此人们不断试图降低＾１４Ｃ－尿素的使用量，但要保持足够准确度（≥９０％），＾１４Ｃ－尿素的用量不可能无限制地降低，那么，最低＾１４Ｃ－尿素的用量是多少呢？本文的目的就在于确定＾１４Ｃ－ＵＢＴ诊断ＨＰ的准确性大于９０％时，所需的＾１４Ｃ－尿素的最低活度。方法     

幽门螺杆菌感染与偏头痛关系的临床研究

目的探讨幽门螺杆菌与偏头痛的关系及作用机制。方法对30例偏头痛患者及35例门诊健康体检者进行^14C-尿素呼气试验法，比较两者幽门螺杆菌阳性发生率及感染程度。结果偏头痛组幽门螺杆菌阳性感染率显著高于对照组（P＜0．01），感染程度（中、重度）也具有重要统计学意义（P〈0．05）。结论幽门螺杆菌感染与偏头痛关系密切，其可能是新的发病因素之一。     

微剂量^14HC-尿素呼气试验诊断幽门螺杆菌感染

本研究旨在评价微剂量(37kBq)^14C-尿素呼气试验(^14C-UBT)对幽仃螺扦菌(Hn感染的诊断教果。106例病人清晨空腹饮下37kBq^14C-尿素水溶液，海胺溶液吸收20分钟呼气CO2；2mm01．液闪仪测定^14C放射性活性．结果以dpm／mmolCO：表达。19例志愿第二日重复试验。以Warthin-Starry组织染色和快速尿素酶试验作为参照标准，ROC分析法确定^14C-UBT最适判别值。结果得出^14C-UBT最适判别值为250dpm／mmol CO2；实验对HP感染诊断的敏感性、特异性和准确性分别为98.3%(58／50)、98．7%(46/47)、和98．7%(104／106)；实验重复性良好；体重校正对诊断效果无影响。研究结果提示散剂量^14C-UBT诊断HP感染具有高度的准确性，且简单和安全；试验无需试餐和加用非标记尿素，结果不需以体重校正。     

幽门螺杆菌检测方法研究新进展

本文就近年来幽门螺杆菌检测方法新进展作一简要的概述,主要从细菌培养、快速尿素酶实验、组织学检查、尿素呼气实验、抗体检测、粪便抗原检测和分子生物学检测等几个方面展开。     

A comparison of diagnostic tests to determine Helicobacter pylori infection

Twenty-five Helicobacter pylori positive and 25 H. pylori negative subjects as defined by culture and phase contrast microscopy of antral biopsy specimens obtained from routine upper endoscopy were studied. Antral biopsies were examined by rapid urease test, phase contrast microscopy, culture and histology. Venous blood was tested for H. pylori specific IgG antibodies by an ELISA technique. Within 7 days of endoscopy the patients also had a [14C]-urea breath test. The sensitivity and specificity of the rapid urease test was 92%, the breath test 96% and 100%, histopathology 96% and 91% and serology 96% and 88%, respectively. The [14C]-urea breath test performed over 1 h with sampling of subjects at 0, 0.5 and 1 h was an accurate and reliable method. Results expressed as counts per minute of the expired 14CO2 proved to be a simple method of assessing H. pylori status. A significant correlation between severity of histological antral gastritis and the amount of 14CO2 expired was observed. This study has shown that the non-invasive 14C-urea breath test and serology are highly sensitive and specific for the diagnosis of H. pylori infection.     

~(14)C-UBT检测具有上消化道症状幽门螺杆菌感染及家庭聚集性的分析

目的探讨具有上消化道症状病人幽门螺杆菌(Helicobacter pylori,H.pylori)感染状况及家庭聚集性。方法对具有上消化道症状而来我院消化科门诊就诊的病人8 750人,进行14C-尿素呼气试验(14C-urea breath test,14C-UBT)检测H.pylori感染,以及对上述病人进行宣教,动员其家庭成员自愿参加该检测项目,其中资料完整的有840个家庭,共2 905人,确定是否存在H.pylori感染,且问卷登记其家庭环境因素如家庭收入和教育状况等。结果 8 570例具有上消化道症状病人中H.pylori总感染率为61.29%,不同年龄组H.pylori感染率不同(χ2=224.672,P0.001),且有典型随年龄增长而上升的趋势,但性别间差异无统计学意义(χ2=0.346,P=0.556)。通过二项分布拟合优度检验探讨H.pylori感染的家庭聚集性,H.pylori感染在家庭内的分布不符合二项分布[χ2=22.05,χ2(0.05,3)=7.81,P0.05不符合二项分布],在理论分布上发现H.pylori感染有家庭聚集性分布趋势,夫妻之间H.pylori感染率情况一致(P=0.494,P0.05),夫妻H.pylori感染的符合率为56.90%。双亲感染家庭儿童的H.pylori感染率为51%高于双亲未感染家庭儿童的H.pylori感染率为29%(χ2=27.102,P0.001)。环境因素良好家庭儿童感染的比例(32%)明显低于环境因素一般(49%)及环境因素较差(56%)的两种家庭(χ2=33.543,P0.001)。结论具有上消化道症状的门诊病人H.pylori感染率较高,性别间差异不明显,家庭成员内H.pylori感染具有聚集性,环境因素与儿童感染H.pylori呈负相关。     

幽门螺杆菌根除治疗前后快速尿素酶试验诊断的准确性

目的 评价快速尿素酶试验(RUT)在根除治疗前后诊断幽门螺杆菌(Hp)感染的准确性。方法 选择250例接受胃镜检查的患者，123例无Hp根除治疗史，127例为Hp根除治疗后复查患者。每例患者取胃窦和胃体活检标本各3块，分别用于RUT、细菌培养和病理组织学检查。以细菌培养及病理组织学检查结果作为“金标准”，即培养和(或)组织学检查结果阳性者为Hp阳性，而培养和组织学检查结果同时阴性者为HP阴性或HP根除。结果 末行Hp根除治疗的患者RUT正确的诊断了86例Hp阳性中的84例和37例Hp阴性中的34例，其敏感性和特异性分别为97．7％和91.9％。根除治疗后RUT敏感性和特异性分别为64.3％和99.0％。然而，根除治疗后6个月以上复查胃镜，RUT敏感性和特异性均达100％。结论 根除治疗前和根除治疗后6个月以上复查，RUT诊断Hp感染准确性高。     

3368例武汉市儿童幽门螺杆菌感染的临床分析

目的了解武汉市有消化道症状的儿童幽门螺杆菌感染状况、分布特征及影响因素。方法选取我院及武汉市医院2010年8月～2011年7月3 368例有消化道症状的儿童,以性别和年龄进行分组,通过14 C-尿素呼气试验检测幽门螺杆菌感染情况,并对其结果进行统计学分析,同时对这些儿童的生活方式进行问卷调查分析。结果 3 368例受检儿童H.pylori总感染率为29.2%,其中男女儿童H.pylori感染阳性率分别为29.2%和29.1%,男女儿童H.pylori感染阳性率差异无统计学意义(P>0.05);学龄前、学龄期及青春期儿童H.pylori感染阳性率分别为27.1%、28.7%和39.1%,学龄前期与学龄期H.pylori感染阳性率差异无统计学意义(P>0.05),学龄前期、学龄期与青春期H.pylori感染阳性率差异有统计学意义(P<0.01);年龄与H.pylori感染阳性率相关(P=0.001);同年龄组男女儿童H.pylori感染阳性率差异无统计学意义(P>0.05);父母幽门螺杆菌阳性患儿幽门螺杆菌阳性率57.5%。结论武汉市有消化道症状的儿童幽门螺杆菌感染率高,随年龄增长感染率递增,但与性别无关,父母幽门螺杆菌阳性患儿幽门螺杆菌阳性率高,年龄、家庭聚集性、父母H.pylori感染与儿童H.pylori感染相关。     

Capsule 13C-urea breath test for the diagnosis of Helicobacter pylori infection

AIM: To compare the accuracy of capsule 13C-urea breath test (UBT) with conventional invasive methods for the diagnosis of Helicobacter pylori infection. METHODS: One hundred patients received CLO test, histological examination, culture and 100- or 50-mg capsule UBT for the diagnosis of H pylori infection. H pylori infection was defined as those with positive culture or positive results from both histology and CLO test. RESULTS: Both the sensitivity and specificity of the 100-mg capsule UBT (n=50) were 100%. The sensitivity and specificity of the 50-mg capsule UBT (n = 50) were 96.4 and 100%, respectively. Taken together, the accuracy of capsule UBT (n =100) was higher than that of CLO test, histology and culture (100% vs 92%, 91% and 89%, respectively; P= 0.035, 0.018 and 0.005, respectively). Our data showed that the optimal timing of sampling for 100-and 50-mg capsule UBT was 15-30 and 6-15 min, respectively. CONCLUSION: Capsule UBT has a higher accuracy compared with biopsy-based tests. It is an ideal method for the diagnosis of H pylori infection.     

诊断幽门螺杆菌感染的几种检查方法比较

本文对200例具有消化道症状的患者进行13C尿素呼气试验,结果13C尿素呼气试验与HPUT、细菌培养、PCR无明显差异;13C尿素呼气试验在诊断HP感染时,方便可靠、特异性和敏感性较高。     

Helicobacter pylori infection and the risk of gastric cancer among the Korean population

Helicobacter pylori infection has been associated with chronic atrophic gastritis, a precursor of gastric cancer. We conducted a prospective, case-controlled study to investigate whether H. pylori infection increases the risk of gastric cancer in Korean people with a high risk of gastric cancer. We enrolled 160 gastric cancer patients who were confirmed by endoscopic biopsy during 1994 and 160 age-matched control subjects with non-ulcer dyspepsia were compared to document the relationship between H. pylori infection and gastric cancer. The presence of H. pylori infection was determined by the rapid urease test and/or histology by Wright-Giemsa staining. The overall presence of H. pylori infection was 60% in gastric cancer patients and 51.9% in age-matched control subjects (odds ratio 1.39; 95% confidence interval 0.894–2.17; P= 0.143). Carcinomas of cardia, body and antrum were not associated with H. pylori infection (odds ratio 1.43, 1.69 and 1.29, respectively; 95% confidence interval, 0.271–7.52, 0.787–3.62 and 0.689–2.43, respectively; P= 0.178, 0.177 and 0.642, respectively) nor was the intestinal or diffuse type of cancer (odds ratio 1.39 and 1.40, respectively; 95% confidence interval 0.791–2.45 and 0.681–2.87, respectively; P= 0.250 and 0.835, respectively). Gender was not a risk for gastric cancer. In contrast to previous studies, these results do not provide evidence of H. pylori infection for gastric carcinogenesis in Korea.     

A 15-minute [13C]-urea breath test for the diagnosis of Helicobacter pylori infection in patients with non-ulcer dyspepsia

BACKGROUND: Non-ulcer dyspepsia (NUD) accounts for the majority of dyspeptic patients and studies on the epidemiology of Helicobacter pylori infection in NUD depend on a non-invasive and rapid diagnostic test. This study was performed to determine the sensitivity and specificity of a 15-min simplified protocol of the [13C]-urea breath test ([13C]-UBT) for the diagnosis of H. pylori infection in patients with NUD. METHODS: One hundred and thirty-six patients with a clinical and endoscopic diagnosis of NUD were included. The [13C]-UBT was modified from the European standard protocol. The baseline breath sample was collected 5 min after the patient took a test meal and the 13CO2 was collected 15 min after the patient drank 100 mg [13C]-urea. The gold standard used for comparison was either a positive culture or positive histology + positive rapid urease test sampled on upper gastrointestinal endoscopy. RESULTS: The prevalence of H. pylori infection in NUD by the gold standard was 59.6%, whereas that calculated by the [13C]-UBT was 60.3%. The sensitivity and specificity of [13C]-UBT was 93.8 and 89.1% compared with the gold standard. The shortened collection time and simplification of the procedure may have led to a decline in specificity. CONCLUSION: The 15-min [13C]-UBT is a rapid but less specific protocol for detecting the presence of H. pylori infection in patients with NUD.     

Analysis of eight different methods for the detection of Helicobacter pylori infection in patients with dyspepsia

BACKGROUND: The present study was designed to compare the accuracy of eight different methods for the detection of Helicobacter pylori (H. pylori) infection in patients with dyspepsia. These tests included culture, histology, rapid urease test (CLO test), serology, saliva IgA, gastric juice IgA, and two in-house methods, namely in-house urease test and Gram stain. METHODS: H. pylori infection was diagnosed prospectively in 200 untreated patients who underwent upper gastrointestinal endoscopy at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between July 1999 and August 2001. The gold standard for H. pylori infection was based on a positive culture or both a positive histological examination and CLO test. RESULTS: The culture provided a sensitivity of 55.9% whereas saliva IgA and gastric juice IgA had a sensitivity of 26.8% and 22.2%, respectively. In contrast, the other tests provided satisfactory sensitivities ranging between 89.3% and 100% (Gram stain 89.3%, histology 93.5%, serology 96.8%, CLO test 99.0%, in-house urease test 100%). The specificities of the tests ranged between 75% and 100% (culture 100%, CLO test 91.9%, histology 90.4%, in-house urease test 88.9%, Gram stain 93.5% serology 96.8%, gastric juice IgA 91.7% and saliva IgA 75%). CONCLUSIONS: Majority of invasive and non-invasive tests in this study were accurate for the diagnosis of H. pylori infection. However, the secretory IgA-based techniques in saliva and gastric juice seem to be inappropriate for determining H. pylori status in our populations due to their low sensitivities.