Adamopoulos A B, Stergiou G S, Sakizlis G N, Tiniakos D G, Nasothimiou E G, Sioutis D K, Achimastos A D
3rd Department of Internal Medicine, University of Athens Medical School, Sotiria Hospital, Athens, Greece.
Dig Liver Dis. 2009 Jan;41(1):4-8. doi: 10.1016/j.dld.2008.05.010. Epub 2008 Jul 7.
The aim of this work was to assess the reliability of rapid urease test (RUT) and urea breath test (UBT) for detecting Helicobacter pylori (H. pylori) in patients with Billroth II (BII) gastrectomy, using histology as reference.
In this prospective controlled study, 31 consecutive patients with BII gastrectomy and 73 controls who had an indication for endoscopy were included. Their H. pylori status was assessed with biopsies for histology, RUT and UBT. Histology served as the gold standard. Only the biopsies from the gastric fundus were evaluated. Specificity, sensitivity, positive and negative predictive value, degree of agreement and k-statistics were used.
RUT and UBT for detecting H. pylori in the control group had excellent agreement [97%, kappa (k)=0.94 and 99%, k=0.97 respectively] with biopsies. In BII patients, RUT from fundic biopsies had very good agreement (87%, k=0.74) compared to histology from fundic biopsies, whereas the UBT was unreliable (agreement: 71%, k=0.41) compared to histology.
The RUT from fundic biopsies in BII patients is a reliable test for H. pylori detection, whereas the UBT is unreliable.
本研究旨在以组织学为参照，评估快速尿素酶试验（RUT）和尿素呼气试验（UBT）检测毕Ⅱ式（BII）胃切除术后患者幽门螺杆菌（H. pylori）感染的可靠性。
在这项前瞻性对照研究中，纳入了31例连续的BII胃切除术后患者以及73例有内镜检查指征的对照者。通过活检进行组织学检查、RUT和UBT来评估他们的幽门螺杆菌感染状况。组织学检查作为金标准。仅评估胃底活检标本。采用特异性、敏感性、阳性和阴性预测值、一致性程度和k统计量进行分析。
对照组中，RUT和UBT检测幽门螺杆菌与活检结果具有高度一致性[分别为97%，kappa（k）=0.94和99%，k=0.97]。在BII患者中，胃底活检的RUT与胃底活检组织学结果具有良好的一致性（87%，k=0.74），而UBT与组织学结果相比不可靠（一致性：71%，k=0.41）。
BII患者胃底活检的RUT是检测幽门螺杆菌的可靠方法，而UBT不可靠。
