Slomianski A, Schubert T, Cutler A F
Department of Gastroenterology, Sinai Hospital, Detroit, Michigan.
Am J Gastroenterol. 1995 Feb;90(2):224-6.
To determine the utility of the [13C]urea breath test in confirming the eradication of Helicobacter pylori.
We reviewed our H. pylori database for patients who underwent [13C]urea breath test at baseline and 6 wk after triple therapy with tetracycline, metronidazole, and bismuth subsalicylate. Baseline infection was defined by the identification of the organism on antral biopsies or a reactive CLO test. Eradication was defined as a negative Warthin-Starry stain and a non-reactive CLO test at 24 h. All patients had a positive baseline [13C]urea breath test defined as [13C] enrichment > 6% at 60 min.
One hundred eighteen H. pylori-infected patients (mean age 58.3 +/- 13.9 yr) met the review criteria (61 duodenal ulcers, 24 gastric ulcers, 33 non-ulcer dyspepsia). In 101/118 patients (86%), H. pylori was successfully eradicated (mean baseline breath test value 25.8 +/- 1.6). Of 101 patients, 95 had a negative 6-wk follow-up breath test (mean 2.2 +/- 0.2, p < 0.001). Of the 6/101 patients in whom treatment was successful, and who remained breath test positive at 6 wk, 4/6 were breath test negative when retested at 3 months. The remaining two patients were lost to follow-up. In 17/118 (14%) patients, H. pylori failed to be eradicated (mean baseline breath test 22.4 +/- 3.6). Fifteen of 17 patients had a positive breath test at 6 wk (mean 19.9 +/- 3.7). Two of 17 with a negative breath test at 6 wk tested positive when the breath test was repeated at 3 months. The sensitivity and specificity of [13C]urea breath test at 6 wk posttreatment are 97% and 71%, respectively. The positive and negative predictive values are 94% and 88%, respectively.
[13C]urea breath test is a sensitive indicator of H. pylori eradication 6 wk after treatment. Antral biopsies are unnecessary to confirm eradication of H. pylori after completion of treatment.
确定[13C]尿素呼气试验在确认幽门螺杆菌根除中的效用。
我们查阅了幽门螺杆菌数据库，其中的患者在基线时以及接受四环素、甲硝唑和次水杨酸铋三联疗法6周后进行了[13C]尿素呼气试验。基线感染通过胃窦活检中发现该病原体或CLO试验呈阳性来定义。根除定义为沃辛-斯塔里染色阴性且24小时CLO试验无反应。所有患者基线[13C]尿素呼气试验均为阳性，定义为60分钟时[13C]富集>6%。
118例幽门螺杆菌感染患者（平均年龄58.3±13.9岁）符合纳入标准（61例十二指肠溃疡，24例胃溃疡，33例非溃疡性消化不良）。101/118例患者（86%）幽门螺杆菌成功根除（基线呼气试验平均值25.8±1.6）。101例患者中，95例6周随访呼气试验为阴性（平均值2.2±0.2，p<0.001）。101例治疗成功且6周时呼气试验仍为阳性的患者中，4/6在3个月复查时呼气试验为阴性。其余2例患者失访。17/118例患者（14%）幽门螺杆菌根除失败（基线呼气试验平均值22.4±3.6）。17例患者中有15例6周时呼气试验为阳性（平均值19.9±3.7）。17例6周时呼气试验为阴性的患者中有2例在3个月重复呼气试验时呈阳性。治疗后6周[13C]尿素呼气试验的敏感性和特异性分别为97%和71%。阳性和阴性预测值分别为94%和88%。
[13C]尿素呼气试验是治疗6周后幽门螺杆菌根除的敏感指标。治疗完成后无需进行胃窦活检来确认幽门螺杆菌的根除情况。
