Division of Gastroenterology Hepatology and Nutrition, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA.
Acta Paediatr. 2017 Mar;106(3):470-477. doi: 10.1111/apa.13724. Epub 2017 Jan 20.
This study assessed the Helicobacter pylori (H. pylori) serum antibody test as a diagnostic screening tool in symptomatic inner city children.
This was a retrospective study of patients aged one to 18 years who were referred to our paediatric gastroenterology department from 2009 to 2013. We included all patients who had H. pylori serum antibodies and/or faecal antigens who underwent esophagogastroduodenoscopy (EGD) for histology, with or without a gastric tissue rapid urease test.
A total of 395 patients had EGDs carried out to evaluate epigastric pain, heartburn and nausea or vomiting, and their overall socio-economic Z-score was -2.62. The histology was positive for H. pylori infection in 52 of 395 patients (13%), and epigastric pain was documented in 45 of these 52 patients (87%). Compared to histology, the serum H. pylori antibody test had a sensitivity of 88.4% and a specificity of 93.4%. The tissue rapid urease test and faecal antigen test had sensitivities of 89.3% and 55.6% and specificities of 89.9% and 98.9%, respectively.
The serum H. pylori antibody test had high sensitivity and specificity, and it was a good diagnostic screening tool in our study. Epigastric pain was strongly associated with a current H. pylori infection in our population.
本研究评估了幽门螺杆菌（H. pylori）血清抗体检测作为有症状的城市内儿童的诊断筛查工具。
这是一项回顾性研究，纳入了 2009 年至 2013 年期间因上腹痛、烧心和恶心或呕吐而转至我们儿科胃肠病学部门的 1 至 18 岁患者。我们纳入了所有进行过食管胃十二指肠镜检查（EGD）以进行组织学检查、同时进行或不进行胃组织快速尿素酶试验的 H. pylori 血清抗体和/或粪便抗原检测的患者。
共有 395 例患者接受了 EGD 检查以评估上腹痛、烧心和恶心或呕吐，他们的整体社会经济 Z 评分是-2.62。395 例患者中，52 例（13%）的组织学检查结果为 H. pylori 感染阳性，这 52 例患者中有 45 例（87%）有上腹痛。与组织学检查相比，血清 H. pylori 抗体检测的敏感性为 88.4%，特异性为 93.4%。组织快速尿素酶试验和粪便抗原检测的敏感性分别为 89.3%和 55.6%，特异性分别为 89.9%和 98.9%。
血清 H. pylori 抗体检测具有较高的敏感性和特异性，是我们研究中的一种良好的诊断筛查工具。在上腹痛与当前 H. pylori 感染在我们的人群中存在强相关性。
