Schilling D, Demel A, Adamek H E, Nüsse T, Weidmann E, Riemann J F
Department of Internal Medicine C (Gastroenterology and Hepatology), Klinikum der Stadt Ludwigshafen, Academical Medical Hospital of the University of Mainz, Bremserstr. 79, D-67063 Ludwigshafen/Rhine, Germany.
Dig Liver Dis. 2003 Apr;35(4):217-21. doi: 10.1016/s1590-8658(03)00058-6.
The reliability of the rapid urease test has not been proven in patients with peptic ulcer bleeding. Some studies show bad diagnostic results with the rapid urease test for gastrointestinal bleeding.
To evaluate the efficacy of the rapid urease test in patients with bleeding gastric or duodenal ulcers.
A total of 96 patients with acute peptic ulcer bleeding without proton pump inhibitor or antibiotic therapy within the last 14 days before bleeding were included into the study. During index endoscopy, specimens for histological and rapid urease test were obtained from the antrum and corpus mucosa of the stomach. Patients were also investigated by the 13C-urea breath test. Diagnostic quality parameters were calculated with the histology and the 13C-urea breath test as reference and compared with a matched control group with uncomplicated ulcers.
The sensitivity of the rapid urease test was 80% and the specificity 100% compared to histology and 13C-urea breath test. The negative predictive value was 75%. These values were statistically significantly different from those of the control group (sensitivity 96%, specificity 100%, negative predictive value 88%).
The exclusive use of the rapid urease test cannot be recommended in patients with peptic ulcer bleeding.
快速尿素酶试验在消化性溃疡出血患者中的可靠性尚未得到证实。一些研究表明，快速尿素酶试验用于胃肠道出血时诊断结果不佳。
评估快速尿素酶试验在胃或十二指肠溃疡出血患者中的疗效。
共有96例急性消化性溃疡出血患者纳入本研究，这些患者在出血前14天内未接受质子泵抑制剂或抗生素治疗。在初次内镜检查时，从胃窦和胃体黏膜获取组织学和快速尿素酶试验标本。患者还接受了13C尿素呼气试验检查。以组织学和13C尿素呼气试验为参照计算诊断质量参数，并与无并发症溃疡的匹配对照组进行比较。
与组织学和13C尿素呼气试验相比，快速尿素酶试验的敏感性为80%，特异性为100%。阴性预测值为75%。这些值与对照组（敏感性96%，特异性100%，阴性预测值88%）在统计学上有显著差异。
不建议在消化性溃疡出血患者中单独使用快速尿素酶试验。
