Gisbert J P, Olivares D, Jimenez I, Pajares J M
Gastroenterology Unit, La Princesa University Hospital, Autonomous University, Playa de Mojácar 29. Urb. Bonanza, 28669 Boadilla del Monte, Madrid, Spain.
Dig Liver Dis. 2006 Apr;38(4):254-9. doi: 10.1016/j.dld.2005.10.022. Epub 2005 Nov 22.
To study if there is a correlation between 13C-urea breath test values prior to treatment and the response to first-line and rescue Helicobacter pylori eradication therapies.
Six-hundred patients with peptic ulcer or functional dyspepsia infected by H. pylori were prospectively studied. Pre-treatment H. pylori infection was established by 13C-urea breath test. Three-hundred and twelve patients were treated with first-line eradication regimen, and 288 received a rescue regimen. H. pylori eradication was defined as a negative 13C-urea breath test, 8 weeks after completion of treatment.
H. pylori eradication was achieved in 444 patients. No statistically significant differences were demonstrated when mean delta 13C-urea breath test values were compared between patients with eradication success and failure (49.4+/-33 versus 49.2+/-31). Differences in mean pre-treatment delta 13CO2 between patients with eradication success/failure were not demonstrated either when first-line or rescue regimens were prescribed. With the cut-off point of pre-treatment delta 13CO2 set at 35 units, sensitivity and specificity for the prediction of H. pylori eradication success was 43 and 60%. The area under the receiver operating characteristic curve evaluating all the cut-off points of the pre-treatment delta 13CO2 for the diagnosis of H. pylori eradication was 0.5. Finally, delta 13CO2 values did not influence the eradication in the logistic regression model.
No correlation was observed between 13C-urea breath test values before treatment and the response to first-line and rescue H. pylori eradication therapies. Therefore, we conclude that the quantification of delta 13CO2 prior to treatment is not useful to predict the success or failure of eradicating therapy.
研究治疗前13C尿素呼气试验值与一线及补救性幽门螺杆菌根除治疗反应之间是否存在相关性。
对600例幽门螺杆菌感染的消化性溃疡或功能性消化不良患者进行前瞻性研究。通过13C尿素呼气试验确定治疗前幽门螺杆菌感染情况。312例患者接受一线根除方案治疗，288例接受补救方案治疗。治疗结束8周后，13C尿素呼气试验结果为阴性定义为幽门螺杆菌根除。
444例患者实现了幽门螺杆菌根除。根除成功与失败患者的平均δ13C尿素呼气试验值比较，未显示出统计学显著差异（49.4±33与49.2±31）。无论是采用一线方案还是补救方案，根除成功/失败患者之间治疗前平均δ13CO2的差异也未得到证实。将治疗前δ13CO2的截断点设定为35单位时，预测幽门螺杆菌根除成功的敏感性和特异性分别为43%和60%。评估治疗前δ13CO2所有截断点对幽门螺杆菌根除诊断的受试者工作特征曲线下面积为0.5。最后，在逻辑回归模型中，δ13CO2值不影响根除情况。
未观察到治疗前13C尿素呼气试验值与一线及补救性幽门螺杆菌根除治疗反应之间存在相关性。因此，我们得出结论，治疗前δ13CO2的定量对预测根除治疗的成功或失败并无帮助。
