Urita Yoshihisa, Maeda Tadashi, Ishihara Susumu, Sugimoto Motonobu, Watanabe Toshiyasu, Domon Kaoru, Miki Kazumasa
Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan.
Hepatogastroenterology. 2007 Sep;54(78):1891-4.
BACKGROUND/AIMS: It is difficult to interpret the results of 13C-urea breath test (UBT) in gastrectomy patients because the test urea may pass through the stomach faster. The aim of this study is to evaluate the efficacy of the modified endoscopic UBT for detection of Helicobacter pylori (H. pylori) infection in the residual stomach.
An endoscopic UBT was performed in 44 patients who had undergone partial gastrectomy. At endoscopy, 20 mL of water containing 100mg of 13C-urea were sprayed onto the gastric mucosa and an intragastric gas sample was immediately collected through the biopsy channel. Breath samples were collected at 20 min after spraying 13C-urea.
The intragastric delta13CO2 value in H. pylori-positive patients was significantly higher than those of 20-minute breath samples. The maximum sensitivity and specificity of intragastric samples were 97% and 100% with cutoff point of 5 per thousand, respectively. The sensitivity and specificity of breath samples at 20 min were 71.4% and 66.7% with cutoff point of 0.6 per thousand, respectively.
An endoscopic UBT was superior to a standard UBT to detect H. pylori infection after partial gastrectomy.
背景/目的：胃切除患者的13C尿素呼气试验（UBT）结果难以解读，因为试验用尿素可能更快通过胃部。本研究旨在评估改良内镜UBT检测残胃中幽门螺杆菌（H. pylori）感染的有效性。
对44例接受部分胃切除术的患者进行内镜UBT。在内镜检查时，将含有100mg 13C尿素的20mL水喷洒在胃黏膜上，并立即通过活检通道采集胃内气体样本。在喷洒13C尿素后20分钟采集呼气样本。
H. pylori阳性患者的胃内δ13CO2值显著高于20分钟呼气样本。胃内样本的最大敏感性和特异性分别为97%和100%，临界值为千分之5。20分钟时呼气样本的敏感性和特异性分别为71.4%和66.7%，临界值为千分之0.6。
内镜UBT在检测部分胃切除术后H. pylori感染方面优于标准UBT。
