萎缩性胃炎患者常规幽门螺杆菌检测的性能。

Performance of routine Helicobacter pylori tests in patients with atrophic gastritis.

机构信息

University of Latvia, Faculty of Medicine, Riga, Latvia.

出版信息

J Gastrointestin Liver Dis. 2011 Dec;20(4):349-54.

PMID:22187698

Abstract

BACKGROUND

Decreased density of H. pylori in atrophic gastritis may lead to low sensitivity of the routine tests.

AIMS

To evaluate the accuracy of routinely used H. pylori tests in atrophic gastritis.

METHODS

We compared 5 H. pylori diagnostic tests in 119 dyspeptic patients (28 males/91 females) with a mean age of 67 years (range 55-84). Patients with gastric cancer, peptic ulcer, previous gastric surgery, or those who have received eradication therapy were excluded. The following tests were performed: histology, rapid urease test (RUT), culture, 13C- urea breath tests (UBT), and H.pylori IgG/IgA antibody test (serology).

RESULTS

Atrophic gastritis was diagnosed in 26.1% of the patients; H. pylori was present in 87.1%. In the group with atrophy, the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were as follows: histology (100% for all parameters); UBT (96; 100; 100; 80; 97%); serology (96; 50; 93; 67; 90%); culture (96; 100; 100; 80; 97%); and RUT (78; 100; 100; 40; 81%), respectively.

CONCLUSIONS

Histology, UBT and culture were the three best tests for diagnosing H. pylori infection. We cannot recommend using serology as a single test in a case of atrophy, but it would be reasonable to combine serology with one of the above tests.

摘要

背景

萎缩性胃炎中幽门螺杆菌密度降低可能导致常规检测的敏感性降低。

目的

评估常规使用的幽门螺杆菌检测方法在萎缩性胃炎中的准确性。

方法

我们比较了 119 例消化不良患者（28 名男性/91 名女性）的 5 种幽门螺杆菌诊断检测方法，患者平均年龄为 67 岁（55-84 岁）。排除胃癌、消化性溃疡、既往胃手术或接受过根除治疗的患者。进行了以下检测：组织学、快速尿素酶试验（RUT）、培养、13C-尿素呼气试验（UBT）和幽门螺杆菌 IgG/IgA 抗体检测（血清学）。

结果

26.1%的患者诊断为萎缩性胃炎；87.1%的患者存在幽门螺杆菌。在有萎缩的组中，组织学的灵敏度、特异性、阳性预测值、阴性预测值和总准确性分别为：组织学（所有参数均为 100%）；UBT（96%；100%；100%；80%；97%）；血清学（96%；50%；93%；67%；90%）；培养（96%；100%；100%；80%；97%）；RUT（78%；100%；100%；40%；81%）。