Cutler A F
Sinai Hospital, Wayne State University, Detroit, Michigan, USA.
Yale J Biol Med. 1998 Mar-Apr;71(2):75-9.
Many diagnostic tests are available to establish Helicobacter pylori infection status. Most of the tests are accurate though none works perfectly, and no gold standard for diagnosis exists. Newly developed serum immunoassay kits can substitute for laboratory-based enzyme-linked immunosorbent assays, but whole blood immunoassays do not yet demonstrate adequate performance characteristics. Serologic diagnosis of H. pylori remains the most cost-effective option and should be utilized to establish initial infection in the majority of cases. If rapid urease testing is performed at endoscopy, negative results can be confirmed with a subsequent serologic test in those patients with a high probability of infection. Obtaining additional gastric tissue at endoscopy to evaluate for bacterial infection is reasonable if specimens are being taken for a mucosal defect. Confirmation of bacterial eradication cannot be justified for all post-treatment patients at present due to the expense. It is important to test for cure in those patients with complicated ulcer disease and those with recurrent symptoms after therapy.
有许多诊断测试可用于确定幽门螺杆菌感染状况。大多数测试都是准确的，尽管没有一个是完美无缺的，而且不存在诊断的金标准。新开发的血清免疫测定试剂盒可以替代基于实验室的酶联免疫吸附测定，但全血免疫测定尚未显示出足够的性能特征。幽门螺杆菌的血清学诊断仍然是最具成本效益的选择，并且在大多数情况下应用于确定初始感染。如果在内镜检查时进行快速尿素酶试验，对于那些感染可能性高的患者，阴性结果可以通过随后的血清学检测来确认。如果因黏膜缺损而采集标本，在内镜检查时获取额外的胃组织以评估细菌感染是合理的。目前，由于费用问题，并非所有治疗后的患者都有理由进行细菌根除的确认。对于那些患有复杂性溃疡病的患者以及治疗后有复发症状的患者，检测是否治愈很重要。
