Oderda G, Rapa A, Marinello D, Ronchi B, Zavallone A
Paediatric clinic, University of Piemonte Orientale, Novara, Italy.
Aliment Pharmacol Ther. 2001 Feb;15(2):203-6. doi: 10.1046/j.1365-2036.2001.00915.x.
The monitoring of the results of eradication treatment is a crucial step for patients with Helicobacter pylori gastritis. A non-invasive test for H. pylori antigens in stools (HpSA) was recently validated for children.
To evaluate the accuracy of HpSA in monitoring eradication treatment in children.
In 60 children, H. pylori gastritis was diagnosed by endoscopy and the 13C-urea breath test. The children were treated and returned for a follow-up (13)C-urea breath test 6 weeks after the end of treatment. Children were considered cured when the (13)C-urea breath test was negative. Stool were collected at baseline, and at 2 and 6 weeks. Stool antigens were measured by HpSA.
According to (13)C-urea breath test, 6 weeks after the end of treatment 49 children were cured and 11 were still H. pylori-positive. The sensitivity and specificity of HpSA on stools collected 2 weeks after therapy were 100%. At 6 weeks specificity was 93.9 and sensitivity 100%. Results by visual reading were concordant with the plate-reader in all but two cases at baseline.
HpSA is accurate for monitoring treatment in children as early as 2 weeks after therapy, when information is most useful and unachievable with other tests. Results by visual reading are accurate, and this can make the test cheaper and more practical.
对于幽门螺杆菌胃炎患者,监测根除治疗的结果是关键步骤。一种用于检测粪便中幽门螺杆菌抗原的非侵入性检测方法(HpSA)最近已在儿童中得到验证。
评估HpSA在监测儿童根除治疗中的准确性。
对60名儿童进行内镜检查和13C尿素呼气试验以诊断幽门螺杆菌胃炎。对这些儿童进行治疗,并在治疗结束6周后返回进行随访13C尿素呼气试验。当13C尿素呼气试验呈阴性时,儿童被视为治愈。在基线、治疗后2周和6周收集粪便。通过HpSA检测粪便抗原。
根据13C尿素呼气试验,治疗结束6周后,49名儿童治愈,11名儿童幽门螺杆菌仍为阳性。治疗后2周收集的粪便中HpSA的敏感性和特异性均为100%。6周时特异性为93.9%,敏感性为100%。除基线时两例病例外,目视读数结果与酶标仪结果一致。
HpSA在治疗后2周即可准确监测儿童治疗情况,此时该信息最为有用且其他检测方法无法获得。目视读数结果准确,这可使检测成本更低且更实用。