消化不良患者幽门螺杆菌的检测及其与临床结局的相关性。

Detection of H. pylori in dyspeptic patients and correlation with clinical outcomes.

作者信息

Chomvarin Chariya, Kulsuntiwong Panthong, Mairiang Pisaln, Sangchan Apichat, Kulabkhow Churairut, Chau-in Siri, Waropastrakul Nareas

机构信息

Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

出版信息

Southeast Asian J Trop Med Public Health. 2005 Jul;36(4):917-22.

PMID:16295546

Abstract

The objectives of this study were to evaluate the methods used to diagnose Helicobacter pylon infection in gastric biopsies, and to evaluate the correlation between H. pylori infection and clinical outcomes. Gastric biopsies, obtained from 210 patients, were evaluated for H. pylori by culture, a commercial rapid urease test (RUT, Pronto Dry) and histological examination. A true positive result was either the culture or both the RUT and histological examination were positive. The results showed a H. pylori infection rate of 44.3% (93/210). The sensitivities, specificities, positive predictive values and negative predictive values were 88.2, 100, 100, and 91.4 % by the culture; 95.7, 98.3, 97.8, and 96.6% by RUT; and 96.8, 59.8, 59.8, and 65.7% by histological examination, respectively. The prevalences of H. pylori in non-ulcer dyspepsia (NUD), peptic ulcer dyspepsia (PUD) and gastric cancer (GCA) patients were 41.2, 57.9 and 70.6%, respectively. The chi-squared-test showed that GCA patients were significantly more frequent infected with H. pylori than NUD patients (p<0.05). Our study indicates that the RUT method was highly sensitive, specific and appropriate for routine clinical use.

摘要

本研究的目的是评估用于诊断胃活检中幽门螺杆菌感染的方法，并评估幽门螺杆菌感染与临床结果之间的相关性。对从210例患者获取的胃活检组织进行培养、商业快速尿素酶试验（RUT，Pronto Dry）和组织学检查，以评估幽门螺杆菌。真正的阳性结果是培养阳性，或RUT和组织学检查均为阳性。结果显示幽门螺杆菌感染率为44.3%（93/210）。培养法的敏感性、特异性、阳性预测值和阴性预测值分别为88.2%、100%、100%和91.4%；RUT法分别为95.7%、98.3%、97.8%和96.6%；组织学检查分别为96.8%、59.8%、59.8%和65.7%。非溃疡性消化不良（NUD）、消化性溃疡消化不良（PUD）和胃癌（GCA）患者中幽门螺杆菌的患病率分别为41.2%、57.9%和70.6%。卡方检验显示，GCA患者感染幽门螺杆菌的频率显著高于NUD患者（p<0.05）。我们的研究表明，RUT方法高度敏感、特异，适用于常规临床应用。