Okuda Masumi, Kamiya Shigeru, Booka Mina, Kikuchi Shogo, Osaki Takako, Hiwatani Tomoko, Maekawa Kohei, Fukuda Yoshihiro
Department of General Medicine and Community Health Science, Hyogo College of Medicine, Sasayama, Japan.
Pediatr Int. 2013 Jun;55(3):337-41. doi: 10.1111/ped.12057.
Rapid urine-HpAb is reported to be a reliable test of Helicobacter pylori infection in adults, but there are no data on the application of the test in children. The aim of this study was to evaluate the accuracy of a urine-based enzyme-linked immunosorbent assay (urine-HpELISA) and immunochromatography (rapid urine-HpAb) kit for anti-H. pylori immunoglobulin G antibody in children. We compared its sensitivity and specificity in reference to the (13) C-urea-breath test (UBT) and H. pylori stool antigen test (HpSA).
In total, 101 Japanese children without significant upper-abdominal symptoms were included (mean age, 7.1 years; range 2-15 years). Their sensitivity and specificity were evaluated in reference to the UBT and HpSA.
Thirty-seven children were judged H. pylori-positive and 64 negative by the UBT and HpSA. No discrepancy in the results was observed between UBT and HpSA. Urine-HpELISA showed 91.9% sensitivity and 96.9% specificity with an accuracy of 95.0%. Rapid urine-HpAb showed 78.4% sensitivity and 100% specificity with an accuracy of 92.1%. Seven false negative results for rapid urine-HpAb were from children aged younger than 10 years, and their antibody titers of urine-HpELISA were lower than true positives.
For the diagnosis of H. pylori infection in Japanese children, both tests are non-invasive, inexpensive, reliable and easy-to-perform methods giving satisfactory accuracy, although the sensitivity of the rapid urine-HpAb kit was inferior to that of the urine-HpELISA kit, especially in children aged younger than 10 years, showing relatively low titer of H. pylori antibody.
据报道，快速尿 HpAb 是成人幽门螺杆菌感染的可靠检测方法，但尚无该检测方法在儿童中应用的数据。本研究旨在评估基于尿液的酶联免疫吸附测定（尿 HpELISA）和免疫层析法（快速尿 HpAb）试剂盒检测儿童抗幽门螺杆菌免疫球蛋白 G 抗体的准确性。我们参照碳 - 13 尿素呼气试验（UBT）和幽门螺杆菌粪便抗原检测（HpSA）比较了其敏感性和特异性。
共纳入 101 名无明显上腹部症状的日本儿童（平均年龄 7.1 岁；范围 2 - 15 岁）。参照 UBT 和 HpSA 评估其敏感性和特异性。
通过 UBT 和 HpSA 判断，37 名儿童为幽门螺杆菌阳性，64 名儿童为阴性。UBT 和 HpSA 结果之间未观察到差异。尿 HpELISA 的敏感性为 91.9%，特异性为 96.9%，准确率为 95.0%。快速尿 HpAb 的敏感性为 78.4%，特异性为 100%，准确率为 92.1%。快速尿 HpAb 的 7 例假阴性结果来自 10 岁以下儿童，且他们的尿 HpELISA 抗体滴度低于真阳性。
对于日本儿童幽门螺杆菌感染的诊断，这两种检测方法均为非侵入性、廉价、可靠且易于操作的方法，准确性令人满意，尽管快速尿 HpAb 试剂盒的敏感性低于尿 HpELISA 试剂盒，尤其是在 10 岁以下、幽门螺杆菌抗体滴度相对较低的儿童中。
