幽门螺杆菌感染的非侵入性诊断：在临床实验室环境中，简化的¹³C尿素呼气试验、粪便抗原检测或人粪便中的DNA聚合酶链式反应？
Non-invasive diagnosis of Helicobacter pylori infection: simplified 13C-urea breath test, stool antigen testing, or DNA PCR in human feces in a clinical laboratory setting?
作者信息
Zambon Carlo-Federico, Basso Daniela, Navaglia Filippo, Mazza Saverio, Razetti Monica, Fogar Paola, Greco Eliana, Gallo Nicoletta, Farinati Fabio, Rugge Massimo, Plebani Mario
机构信息
Department of Medical and Surgical Sciences, University of Padova, Italy.
出版信息
Clin Biochem. 2004 Apr;37(4):261-7. doi: 10.1016/j.clinbiochem.2003.12.004.
OBJECTIVES
(1) To compare two stool antigen EIAs (HpSA, FemtoLab) and PCR of ureaseA and cagA in feces, with (13)C-urea breath test (UBT). (2) To ascertain whether a simplified UBT (breath collection time = 10 min) is as reliable as the standard assay (30 min).
DESIGN AND METHODS
Helicobacter pylori status was recorded in Group 1 (n = 187) by UBT, H. pylori stool antigen, ureA and cagA PCR in feces. UBT with 10, 20 and 30 min sampling was performed in Group 2 patients (n = 283).
RESULTS
The sensitivity and specificity of HpSA, FemtoLab, and ureA were 67% and 99%, 90% and 96%, 35% and 98%, respectively. cagA results were positive in 16/48 H. pylori-positive, and in 5/100 H. pylori-negative patients. The results of UBT with a 10- and 30-min sampling strictly overlapped.
CONCLUSION
UBT with 10 min breath collection and FemtoLab stool antigen assay are the most reliable non-invasive tests to diagnose H. pylori infection.
目的
（1）比较两种粪便抗原酶免疫测定法（幽门螺杆菌粪便抗原检测、飞米实验室检测）以及粪便中尿素酶A和细胞毒素相关基因A（cagA）的聚合酶链反应（PCR）与碳-13尿素呼气试验（UBT）。（2）确定简化的UBT（呼气收集时间 = 10分钟）是否与标准检测方法（30分钟）一样可靠。
设计与方法
在第1组（n = 187）中，通过UBT、幽门螺杆菌粪便抗原、粪便中尿素酶A和cagA的PCR记录幽门螺杆菌感染状况。在第2组患者（n = 283）中进行了10分钟、20分钟和30分钟采样的UBT。
结果
幽门螺杆菌粪便抗原检测、飞米实验室检测和尿素酶A的敏感性和特异性分别为67%和99%、90%和96%、35%和98%。在48例幽门螺杆菌阳性患者中有16例cagA结果呈阳性，在100例幽门螺杆菌阴性患者中有5例呈阳性。10分钟和30分钟采样的UBT结果完全重叠。
结论
10分钟呼气收集的UBT和飞米实验室粪便抗原检测是诊断幽门螺杆菌感染最可靠的非侵入性检测方法。
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