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[幽门螺杆菌感染诊断中所选检测方法的评估]

[Assessment of selected tests in diagnostics of Helicobacter pylori infections].

作者信息

Iwańczak Franciszek, Pytrus Tomasz, Iwańczak Barbara, Gościniak Grazyna, Witkowska-Vogtt Ewa, Dzierzanowska Danuta, Laszewicz Wiktor

机构信息

Akademia Medyczna we Wrocławiu, II Katedra i Klinika Pediatrii, Gastroenterologii i Zywienia.

出版信息

Pol Merkur Lekarski. 2005 Jul;19(109):52-6.

Abstract

UNLABELLED

In the diagnostics of Helicobacter pylori infections the invasive and noninvasive methods are applied. In the epidemiological studies the measurement of antibodies of IgG class against H. pylori in the serum or the respiratory test is used. The aim of the study was comparative evaluation of diagnosing of H. pylori infection on the basis of the measurement of antibodies in the serum, HpFL antigens in stool and culture of biopsy specimens from the gastric mucous.

MATERIAL AND METHODS

The study included 380 children aged 1-18 years drawn randomly for epidemiological analysis of H. pylori infection in Lower Silesia in the year 2001. The study was conducted in the year 2002. In all children the concentration of antibodies against H. pylon' of IgG class in the serum using the ELISA method as well as H. pylori antigen (HpFL) in stool were determined. In 66 children out of the whole group the measurements of antibodies using ELISA method and immunoblotting as well as HpFL test were compared to the results of H. pylori culture. Additionally the Hp Cag (+) strains were determined.

RESULTS

The study demonstrated that in 10% of patients with negative results of IgG class antibodies against H. pylori measurement in the serum (below 24 U/ml) the HpFL test in stool was positive. The sensitivity of the test was 58.9%, specificity 90.0%. The correspondence of HpFL test with positive test for the antibodies in the serum was 90% for the antibodies concentration above 500 U/ml. Assuming that a definite test for the H. pylori infection is culture, the most accurate test for detection of the infection turned out to be the determination of the antigen in the stool and immunoblotting. The parallel increase of antibodies titre together with the increase of prevalence of infection with Hp Cag (+) strains was demonstrated.

CONCLUSIONS

The results of HpFL test in stool samples are comparable to the culture, immunoblotting and antibodies concentration in the serum above 100 U/ml.

摘要

未标注

在幽门螺杆菌感染的诊断中,应用了侵入性和非侵入性方法。在流行病学研究中,使用血清中抗幽门螺杆菌IgG类抗体的检测或呼吸试验。本研究的目的是基于血清抗体检测、粪便中HpFL抗原检测以及胃黏膜活检标本培养,对幽门螺杆菌感染的诊断进行比较评估。

材料与方法

该研究纳入了2001年从下西里西亚随机抽取的380名1至18岁儿童,用于幽门螺杆菌感染的流行病学分析。研究于2002年进行。对所有儿童采用酶联免疫吸附测定法(ELISA)测定血清中抗幽门螺杆菌IgG类抗体的浓度,并测定粪便中的幽门螺杆菌抗原(HpFL)。在整个研究组的66名儿童中,将ELISA法、免疫印迹法检测抗体以及HpFL检测的结果与幽门螺杆菌培养结果进行比较。此外,还测定了Hp Cag(+)菌株。

结果

研究表明,血清中抗幽门螺杆菌IgG类抗体检测结果为阴性(低于24 U/ml)的患者中,10%的粪便HpFL检测呈阳性。该检测的敏感性为58.9%,特异性为90.0%。对于抗体浓度高于500 U/ml的情况,粪便HpFL检测与血清抗体阳性检测的一致性为90%。假设幽门螺杆菌感染的确切检测方法是培养,那么检测感染最准确的方法是粪便抗原检测和免疫印迹法。研究还表明,随着Hp Cag(+)菌株感染患病率的增加,抗体滴度也平行升高。

结论

粪便样本中HpFL检测的结果与培养、免疫印迹法以及血清中抗体浓度高于100 U/ml时的结果相当。

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