Thong-Ngam Duangporn, Chayanupatkul Maneerat, Vongchampa Piya, Hanvivatvong Orrawadee
Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 2011 Aug;94(8):985-90.
Non-invasive tests play significant roles in the test-and-treat approach of Helicobacter pylori management. The detection of Helicobacter pylori antibodies in urine and serum is an easy and inexpensive way to diagnose this infection. In the present study, the authors developed an in-house serum and urine ELISA tests for H. pylori antibodies and evaluated their performance in a Thai population.
One hundred thirty eight dyspeptic patients were recruited. All subjects underwent upper endoscopy and one antral biopsy was obtained for rapid urease test, which was used as a standard reference. Urine and serum samples were collected before the procedure to run in-house ELISA test.
Thirty (22%) subjects were positive for the rapid urease test and 108 (78%) were negative. Urine and serum optical density were significantly lower in the urease negative group (p = 0.011 and p < 0.001 respectively), while there were no differences in age, gender, or endoscopic findings between the two groups. Sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of urine and serum ELISA tests were 72% vs. 96.3%, 63.5% vs. 627%, 89.6% vs. 98.5%, 33.3% vs. 40.6%, and 64.5% vs. 69.8% respectively.
In-house serum ELISA test for H. pylori antibodies yielded a very good sensitivity with acceptable specificity, whereas urine ELISA was unable to produce satisfactory sensitivity or specificity
非侵入性检测在幽门螺杆菌管理的检测与治疗方法中发挥着重要作用。检测尿液和血清中的幽门螺杆菌抗体是诊断这种感染的一种简便且经济的方法。在本研究中,作者开发了一种用于检测幽门螺杆菌抗体的内部血清和尿液酶联免疫吸附测定(ELISA)试验,并在泰国人群中评估了它们的性能。
招募了138名消化不良患者。所有受试者均接受了上消化道内镜检查,并获取了一块胃窦活检组织用于快速尿素酶试验,该试验用作标准参考。在检查前收集尿液和血清样本以进行内部ELISA试验。
30名(22%)受试者快速尿素酶试验呈阳性,108名(78%)呈阴性。尿素酶阴性组的尿液和血清光密度显著较低(分别为p = 0.011和p < 0.001),而两组之间在年龄、性别或内镜检查结果方面没有差异。尿液和血清ELISA试验的敏感性、特异性、阴性预测值、阳性预测值和准确性分别为72%对96.3%、63.5%对62.7%、89.6%对98.5%、33.3%对40.6%以及64.5%对69.8%。
用于检测幽门螺杆菌抗体的内部血清ELISA试验具有非常好的敏感性和可接受的特异性,而尿液ELISA无法产生令人满意的敏感性或特异性