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[快速尿素酶试验检测胃黏膜幽门螺杆菌定植情况]

[A rapid urease test in Campylobacter pylori colonization of the gastric mucosa].

作者信息

Bornschein W, Bauernfeind A, Heilmann K L

机构信息

Gastroenterologischen Fachpraxis, Max-von-Pettenkofer-Institut, München.

出版信息

Gastroenterol J. 1989;49(2):54-8.

PMID:2679659
Abstract

Biopsies from the gastric mucosa (antrum, corpus) of 145 patients investigated by endoscopy were analysed for Campylobacter pylori. The results of bacteriological, histological, enzymatic and chemical methods were compared. Urease activity was determined both in biopsies (CLO-test) and in gastric secretion. Furthermore, the concentration of urea was measured in gastric secretion. 71% of gastritis, 86% of ulcus duodeni and 83% of ulcus ventriculi diagnosed by endoscopy produced positive histological and/or cultural results, while 100% of control persons exhibited negative for both parameters. The sensitivity of the CLO-test (n = 112) was 95% and its specificity 78% when compared with bacteriological and histological results. The majority of false positive results was due to delayed and incomplete reactions. However, when compared with endoscopic-histological results the specificity of the CLO-test was 100%. The results of a modification of CLO-test (without culture medium) were up to 5 hours comparable. There was no positive correlation between the concentration of urea in gastric secretion and the histological or cultural identification of Campylobacter pylori. However, the measurement of ammonia turned out to be promising (sensitivity 80%). None of the tests was sufficiently specific on its own, whereas a 100% specificity was achieved when both the CLO-test and the determination of ammonia in gastric secretion were performed.

摘要

对145例接受内镜检查的患者胃黏膜(胃窦、胃体)活检标本进行幽门弯曲菌分析。比较了细菌学、组织学、酶学和化学方法的结果。在活检标本(CLO试验)和胃分泌物中均测定了尿素酶活性。此外,还测定了胃分泌物中尿素的浓度。经内镜诊断的胃炎患者中有71%、十二指肠溃疡患者中有86%、胃溃疡患者中有83%的组织学和/或培养结果呈阳性,而100%的对照者这两项指标均为阴性。与细菌学和组织学结果相比,CLO试验(n = 112)的敏感性为95%,特异性为78%。大多数假阳性结果是由于反应延迟和不完全所致。然而,与内镜-组织学结果相比,CLO试验的特异性为100%。改良的CLO试验(无培养基)结果在长达5小时内具有可比性。胃分泌物中尿素浓度与幽门弯曲菌的组织学或培养鉴定之间无正相关。然而,氨的测定结果显示有前景(敏感性80%)。没有一种检测方法本身具有足够的特异性,而当同时进行CLO试验和胃分泌物中氨的测定时,可实现100%的特异性。

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