Cutler A F, Toskes P
DMC-Sinai Hospital, Wayne State University, Detroit, Michigan 48235, USA.
Am J Gastroenterol. 1999 Apr;94(4):959-61. doi: 10.1111/j.1572-0241.1999.994_q.x.
It has been determined that the [13C]urea breath test (UBT) is a safe and effective way of detecting Helicobacter pylori (H. pylori) infection. Some individuals may have difficulty performing the exhalation component of the test, possibly due to age, or mental or physical compromise. Our aim was to determine if a commercially developed [13C]urea blood test could be utilized as a substitute for the UBT to detect H. pylori infection.
Patients who were referred by their physicians for UBT were offered study inclusion. Patients underwent baseline and 30-min UBT. A simultaneous blood sample of 3 cc was drawn into a heparinized vacutainer at the 30-min period of the UBT. [13C]urea levels in both blood and breath samples were analyzed using isotope ratio mass spectrometry. UBT > or = 6 delta per mil over baseline and urea blood tests > (-17 delta per mil) were considered positive.
One hundred sixty-one patients (68 men/93 women) with average age of 47.0 +/- 14.2 yr were tested. Agreement between breath and blood test results occurred in 153/161 (95%) cases. Using the UBT as the diagnostic standard, the urea blood test resulted in 44 true positive, 109 true negative, four false positive, and four false negative results, giving a sensitivity of 92%, specificity of 96%, positive predictive value of 92%, and negative predictive value of 96%.
The urea blood test was found to be comparable to the urea breath test in the detection of H. pylori infection. The urea blood test will be accurate in the diagnosis of active H. pylori infection.
已确定[¹³C]尿素呼气试验（UBT）是检测幽门螺杆菌（H. pylori）感染的一种安全有效的方法。一些个体可能在进行该试验的呼气部分时存在困难，这可能是由于年龄、精神或身体状况不佳所致。我们的目的是确定一种商业开发的[¹³C]尿素血液检测是否可作为UBT的替代方法来检测H. pylori感染。
被医生转诊进行UBT的患者被邀请纳入研究。患者接受基线和30分钟的UBT。在UBT的30分钟时，同时采集3毫升血液样本至肝素抗凝真空管中。使用同位素比率质谱法分析血液和呼气样本中的[¹³C]尿素水平。UBT较基线升高≥6‰且尿素血液检测＞（-17‰）被视为阳性。
对161例患者（68例男性/93例女性）进行了检测，平均年龄为47.0±14.2岁。呼气和血液检测结果在153/161（95%）的病例中一致。以UBT作为诊断标准，尿素血液检测得出44例假阳性、109例假阴性、4例假阳性和4例假阴性结果，灵敏度为92%，特异性为96%，阳性预测值为92%，阴性预测值为96%。
发现尿素血液检测在检测H. pylori感染方面与尿素呼气试验相当。尿素血液检测在诊断活动性H. pylori感染方面将是准确的。
