Gisbert J P, Gomollón F, Domínguez-Muñoz J E, Borda F, Jiménez I, Vázquez M A, Gallego S, Iglesias J, Pastor G, Pajares J M
Servicios de Aparato Digestivo. Hospital Universitario de la Princesa. Madrid. Spain.
Gastroenterol Hepatol. 2003 Mar;26(3):141-6. doi: 10.1016/s0210-5705(03)79061-x.
To compare the accuracy of the breath test using the isotope ratio mass spectrometer (IRMS) versus the nondispersive isotope-selective infrared spectrometer (NDIRS) in the diagnosis of Helicobacter pylori infection.
Multicenter study in 4 Spanish hospitals. One group of dyspeptic patients who had not undergone prior eradication therapy and another group of patients with gastric ulcer or gastrointestinal bleeding due to gastroduodenal ulcer receiving H. pylori eradication therapy were included in the study. A reference standard based on histology and the rapid urease test was used. The breast test (TAU-KIT, Isomed S.L., Madrid, Spain) was performed with citric acid and 100 mg of 13C-urea. Samples of expired air were collected in tubes and bags for reading with the IRMS (ABCA, PDZ, Crewe, Manchester, England) and the NDIRS (UBiT-IR200, Otsuka Electronics, Co, Osaka, Japan), respectively. The endoscopist, pathologist and person responsible for reading the urease test and both breath tests were blinded to the results of the other diagnostic methods.
Forty-one patients were included. The prevalence of H. pylori was 26%. No differences were found on comparing the mean values obtained with the IRMS and the NDIRS: 13 (standard deviation) (24) and 14 (25) delta units, respectively. The area under the ROC curve for the IRMS and the NDIRS was 0.96. The diagnostic accuracy for the best cut-off point with the IRMS and the NDIRS was, respectively: sensitivity (90 and 100%), specificity (96 and 89%), positive predictive value (90 and 77%), negative predictive value (96 and 100%), + likelihaod ratio (25 and 9.3) and (0.1 and 0). A close correlation was found between the values of the IRMS and those of the NDIRS (lineal regression equation, Y = 1.1 + 1.004. X; r = 0.97).
Both the spectrometers used to evaluate the breath test, the IRMS and the NDIRS, offer a high degree of accuracy in the diagnosis of H. pylori infection.
比较使用同位素比率质谱仪（IRMS）与非分散同位素选择性红外光谱仪（NDIRS）进行呼气试验诊断幽门螺杆菌感染的准确性。
在4家西班牙医院进行的多中心研究。研究纳入了一组未接受过根除治疗的消化不良患者以及另一组因胃十二指肠溃疡接受幽门螺杆菌根除治疗的胃溃疡或胃肠道出血患者。采用基于组织学和快速尿素酶试验的参考标准。使用柠檬酸和100毫克13C尿素进行呼气试验（TAU-KIT，Isomed S.L.，马德里，西班牙）。分别收集呼出气体样本于试管和袋子中，用于使用IRMS（ABCA，PDZ，克鲁，曼彻斯特，英国）和NDIRS（UBiT-IR200，大塚电子株式会社，大阪，日本）进行读数。内镜医师、病理学家以及负责读取尿素酶试验和两种呼气试验结果的人员对其他诊断方法的结果均不知情。
纳入41例患者。幽门螺杆菌感染率为26%。比较IRMS和NDIRS获得的平均值未发现差异：分别为13（标准差）（24）和14（25）δ单位。IRMS和NDIRS的ROC曲线下面积为0.96。IRMS和NDIRS最佳截断点的诊断准确性分别为：敏感性（90%和100%）、特异性（96%和89%）、阳性预测值（90%和77%）、阴性预测值（96%和100%）、+似然比（25和9.3）以及（0.1和0）。发现IRMS和NDIRS的值之间存在密切相关性（线性回归方程，Y = 1.1 + 1.004X；r = 0.9）。
用于评估呼气试验的两种光谱仪，即IRMS和NDIRS，在诊断幽门螺杆菌感染方面均具有高度准确性。
