血清学在评估幽门螺杆菌根除情况中起什么作用？

What is the role of serology in assessing Helicobacter pylori eradication?

作者信息

Bergey B, Marchildon P, Peacock J, Mégraud F

机构信息

Laboratoire de Bactériologie, Université Victor Segalen Bordeaux 2, Bordeaux, France.

出版信息

Aliment Pharmacol Ther. 2003 Sep 15;18(6):635-9. doi: 10.1046/j.1365-2036.2003.01716.x.

DOI:10.1046/j.1365-2036.2003.01716.x

PMID:12969090

Abstract

AIM

To assess the decline in Helicobacter pylori antibodies after eradication of infection.

METHODS

The H. pylori status was determined at entry (D0) by culture and histology performed on antral biopsies and after eradication treatment at day 42 (day 42) and after 6 months (M6) by the 13C-urea breath test. The EIA kits used to determine the anti-H. pylori antibody titre were HM-CAP (immunoglobulin-G) and PP-CAP (immunoglobulin-A) kits (Enteric Products, Inc.) and Pyloriset EIA-G (Orion Diagnostica).

RESULTS

Ninety-three patients were included. For 82 patients who were successfully treated, no kit was sufficiently accurate at D42 to show eradication. The antibody titre decreased for HM-CAP, PP-CAP and Pyloriset EIA-G by a mean of 35.6%, 41.2% and 64.7% between D0 and M6, respectively. According to the cut-off values defined by the manufacturers, 8.5% (PP-CAP, Pyloriset EIA-G) and 9.7% (HM-CAP) of the patients became H. pylori negative at M6. Using a 25% decrease in antibody titre between D0 and M6 as a threshold for H. pylori eradication, specificity was 100% for HM-CAP, 89.9% for Pyloriset EIA-G and 100% for PP-CAP, whereas the sensitivity was 76.8%, 98.8% and 72%, respectively.

CONCLUSION

An antibody titre decrease of 25% at M6 was found to be accurate in confirming H. pylori eradication.

摘要

目的

评估幽门螺杆菌感染根除后抗体水平的下降情况。

方法

通过对胃窦活检组织进行培养和组织学检查，在入组时（D0）确定幽门螺杆菌感染状态；在根除治疗后第42天（第42天）和6个月后（M6），采用¹³C - 尿素呼气试验确定感染状态。用于测定抗幽门螺杆菌抗体滴度的酶免疫分析试剂盒有HM - CAP（免疫球蛋白G）和PP - CAP（免疫球蛋白A）试剂盒（肠道产品公司）以及Pyloriset EIA - G（奥立安诊断公司）。

结果

共纳入93例患者。对于82例成功治疗的患者，在第42天时没有一种试剂盒能足够准确地显示根除情况。在D0至M6期间，HM - CAP、PP - CAP和Pyloriset EIA - G试剂盒的抗体滴度平均分别下降了35.6%、41.2%和64.7%。根据制造商定义的临界值，在M6时，8.5%（PP - CAP、Pyloriset EIA - G）和9.7%（HM - CAP）的患者幽门螺杆菌检测呈阴性。以D0至M6期间抗体滴度下降25%作为幽门螺杆菌根除的阈值，HM - CAP的特异性为100%，Pyloriset EIA - G为89.9%，PP - CAP为100%，而敏感性分别为76.8%、98.8%和72%。