Daino Diego Federico, Soifer Luis, Pedestá José, Rome Juan
Acta Gastroenterol Latinoam. 2015 Mar;45(1):12-7.
In Argentina we have little access to the more sensitive and specific non-invasive diagnostic methods for the detection of Helicobacter pylori (HP), such as the urea breath test. The upper gastrointestinal videoendoscopy, with biopsy for histological analysis and rapid urease test remains as the usual method in our country, but the cost is high and the accessibility is also limited. For this reason we propose to develop a new fast, accurate, accessible and inexpensive method for measuring the concentration of expired NH in order to achieve a diagnosis of active infection.
To determine the utility of a non-invasive method for detecting HP through the measurement of ammonia in the breathing.
We studied 3 patients older than 21 years, attending the Gastroenterology clinic. All patients who meet the inclusion criteria were evaluated with an upper gastrointestinal videoendoscopy and gastric biopsies (antrum, body and incisura angularis). Samples were analyzed by histopathological examination and urease test. The subjects with both negative tests (non-infected) or positive (infected) were selected for ammonia measurement in exhaled air.
The prevalence of HP infection was 60.9% (14 patients). Ten of these patients had significant differences between the baseline ammonia and the ammonia after urea ingestion, yielding a specifcity of 88.9% and a sensitivity of 71.43%, with a Jouden index higher than 50%.
Although the experience must be carried forward, the results of this pilot study suggest that the measurement of ammonia in breath test after ingestion of unmarked urea would be applicable as a diagnostic test for HP, taking into account its low cost and easy management compared to conventional non-invasive methods.
在阿根廷，我们很难获得用于检测幽门螺杆菌（HP）的更敏感、更特异的非侵入性诊断方法，如尿素呼气试验。上消化道视频内镜检查，结合活检进行组织学分析和快速尿素酶试验，仍然是我国常用的方法，但成本高且可及性有限。因此，我们建议开发一种新的快速、准确、可及且廉价的方法来测量呼出氨气的浓度，以实现对活动性感染的诊断。
通过测量呼出气体中的氨来确定一种检测幽门螺杆菌的非侵入性方法的实用性。
我们研究了3名年龄超过21岁、在胃肠病诊所就诊的患者。所有符合纳入标准的患者均接受上消化道视频内镜检查和胃活检（胃窦、胃体和胃角切迹）。样本通过组织病理学检查和尿素酶试验进行分析。选择两项检测均为阴性（未感染）或阳性（感染）的受试者进行呼出空气中氨的测量。
幽门螺杆菌感染率为60.9%（14例患者）。其中10例患者在摄入尿素前后的基线氨和氨之间存在显著差异，特异性为88.9%，敏感性为71.43%，尤登指数高于50%。
尽管必须继续积累经验，但这项初步研究的结果表明，与传统的非侵入性方法相比，摄入未标记尿素后进行呼气试验测量氨，鉴于其成本低且易于操作，可作为幽门螺杆菌的诊断试验。
