[尿素酶快速检测法在消化性溃疡所致上消化道出血患者中检测幽门螺杆菌的应用价值]

[Utility of urease rapid test for detection of Helicobacter pylori in patients with upper gastrointestinal bleeding from peptic ulcer].

作者信息

Bravo Paredes Eduar, Guzmán Rojas Patricia, Gallegos López Roxana, Corzo Maldonado Manuel, Zegarra Chang Arturo, Surco Ochoa Yolanda, Piscoya Rivera Alejandro, Huerta-Mercado Tenorio Jorge, Prochazka Zárate Ricardo, De Los Ríos Senmache Raúl, Pinto Valdivia José

机构信息

Médico Residente de Gastroenterología del Hospital Nacional Cayetano Heredia. Lima, Perú.

出版信息

Rev Gastroenterol Peru. 2011 Jan-Mar;31(1):17-20.

PMID:21544151

Abstract

BACKGROUND

Peptic ulcer disease is the main cause of upper gastrointestinal bleeding and Helicobacter pylori is its principal etiology. The sensitivity of the diagnostics tests is low for the detection of H. pylori en the setting of bleeding peptic ulcer. In addition there are different results among them.

GOAL

To validate the rapid urease test (RUT) in patients with bleeding peptic ulcer.

STUDY

We prospectively included patients older than 14 years old who presented with bleeding peptic ulcer and performed diagnostic studies of RUT and histology for the detection of H. pylori. Two biopsies were taken (one from the antrum and another one from the corpus) for RUT and four biopsies (two from both antrum and corpus) for histology. RESULTS Ninety-three patients were included, gastric ulcer was the most frequent site of the bleeding. 48 patients were positive for H. pylori by histology studies and 55 patients were positive to H. pylori by RUT. The sensitivity and specificity of the RUT were 89.6% (IC 77.3-96.5) y 73.3% (IC 58.0-85.4) respectively.

CONCLUSION

The RUT has a high sensitivity for the detection of H. pylori en the setting of bleeding peptic ulcer.

摘要

背景

消化性溃疡是上消化道出血的主要原因，幽门螺杆菌是其主要病因。在出血性消化性溃疡患者中，诊断测试检测幽门螺杆菌的敏感性较低。此外，这些测试结果存在差异。

目的

验证出血性消化性溃疡患者的快速尿素酶试验（RUT）。

研究

我们前瞻性纳入了14岁以上出现出血性消化性溃疡的患者，并进行了RUT和组织学诊断研究以检测幽门螺杆菌。取两块活检组织（一块来自胃窦，另一块来自胃体）用于RUT，取四块活检组织（两块来自胃窦，两块来自胃体）用于组织学检查。结果纳入了93例患者，胃溃疡是最常见的出血部位。组织学研究显示48例患者幽门螺杆菌阳性，RUT显示55例患者幽门螺杆菌阳性。RUT的敏感性和特异性分别为89.6%（95%可信区间77.3 - 96.5）和73.3%（95%可信区间58.0 - 85.4）。