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一项关于在中国幽门螺杆菌根除治疗前后使用当前感染标志物进行血清学检测的评估。

An evaluation of a serologic test with a current infection marker of Helicobacter pylori before and after eradication therapy in Chinese.

作者信息

Wang Xiao Yong, Yang Yang, Shi Rui Hua, Ho Bo, Wang Hong Di, Zhang Guo Xin

机构信息

Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Helicobacter. 2008 Feb;13(1):49-55. doi: 10.1111/j.1523-5378.2008.00578.x.

Abstract

BACKGROUND AND AIMS

Development of an accurate and less cumbersome noninvasive method to detect current Helicobacter pylori infection is essential in clinic. The aim of this study was to evaluate the performance of the CIM test, also known as the Assure H. pylori Rapid Test (Genelabs Diagnostics Pty. Ltd., Singapore), for the diagnosis of current H. pylori infection before and after eradication therapy in Chinese population.

METHODS

A total of 452 eligible people were recruited for this study in Jiangsu Province, China. Each individual underwent a 13C urea breath test (13C-UBT). For the evaluation of CIM test after eradication, 115 H. pylori-positive outpatients were treated with 1-week triple therapy. One month after the end of therapy, the patients underwent 13C-UBT again, and the CIM-test was performed 1, 3, and 6 months after the end of therapy. Its performance (sensitivity, specificity, positive and negative predictive values, and accuracy) were determined using the 13C-UBT as a gold standard for H. pylori diagnosis.

RESULTS

H. pylori was detected in 221 (65.6%) of the 337 people by 13C-UBT. The sensitivity, specificity, positive and negative predictive values, and accuracy of the CIM test were 93.2%, 90.5%, 94.9%, 87.5%, and 92.3%, respectively, using 13C-UBT as a gold standard. One month after eradication therapy, the sensitivity, specificity of CIM test were only 50% and 66.7%, 66.7% and 84.6% 3-month after eradication therapy and the sensitivity, specificity increased to 85.7% and 96.9%, respectively, when CIM test was used 6 months after the end of anti-H. pylori therapy.

CONCLUSIONS

The CIM test is a simple, rapid, accurate, cheap, and near-people test. It may be satisfactory for detecting H. pylori infection in cases without eradication therapy, but it could not differentiate the past or current infection correctly within 6 months after anti-H. pylori therapy.

摘要

背景与目的

开发一种准确且操作简便的非侵入性方法来检测当前幽门螺杆菌感染在临床上至关重要。本研究的目的是评估CIM检测(也称为Assure幽门螺杆菌快速检测,新加坡基因实验室诊断私人有限公司)在中国人群根除治疗前后对当前幽门螺杆菌感染的诊断性能。

方法

在中国江苏省共招募了452名符合条件的人。每个人都接受了13C尿素呼气试验(13C-UBT)。为了评估根除后CIM检测的效果,对115名幽门螺杆菌阳性门诊患者进行了为期1周的三联疗法治疗。治疗结束1个月后,患者再次接受13C-UBT检测,并在治疗结束后1、3和6个月进行CIM检测。以13C-UBT作为幽门螺杆菌诊断的金标准,确定其性能(敏感性、特异性、阳性和阴性预测值以及准确性)。

结果

通过13C-UBT在337人中检测到221人(65.6%)感染幽门螺杆菌。以13C-UBT作为金标准,CIM检测的敏感性、特异性、阳性和阴性预测值以及准确性分别为93.2%、90.5%、94.9%、87.5%和92.3%。根除治疗1个月后,CIM检测的敏感性、特异性分别仅为50%和66.7%;根除治疗3个月后分别为66.7%和84.6%;在抗幽门螺杆菌治疗结束6个月后进行CIM检测时,敏感性、特异性分别提高到85.7%和96.9%。

结论

CIM检测是一种简单、快速、准确、廉价且贴近患者的检测方法。在未进行根除治疗时检测幽门螺杆菌感染可能令人满意,但在抗幽门螺杆菌治疗后6个月内无法正确区分既往感染或当前感染。

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