发展中国家幽门螺杆菌感染的诊断：两种酶联免疫吸附测定法的比较及血清流行率研究

Diagnosis of Helicobacter pylori infection in a developing country: comparison of two ELISAs and a seroprevalence study.

作者信息

Bodhidatta L, Hoge C W, Churnratanakul S, Nirdnoy W, Sampathanukul P, Tungtaem C, Raktham S, Smith C D, Echeverria P

机构信息

Department of Bacteriology, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.

出版信息

J Infect Dis. 1993 Dec;168(6):1549-53. doi: 10.1093/infdis/168.6.1549.

DOI:10.1093/infdis/168.6.1549

PMID:8245544

Abstract

Serology to detect antibodies to Helicobacter pylori is not frequently used as a diagnostic tool in developing countries. When compared to a commercial ELISA, an ELISA constructed and validated in Thailand had a higher sensitivity (98% vs. 85%), specificity (76% vs. 66%), and negative predictive value (97% vs. 76%) for the detection of H. pylori infection among 104 patients with dyspepsia evaluated by endoscopy. The positive predictive value was 88% for both tests. Serum antibody levels fell significantly 5-8 months after eradication of infection in 8 Thai patients (P = .009). By 8 years of age, > 50% of Thai persons living in urban and rural locations were seropositive. The low negative predictive value of the commercial ELISA limits the usefulness of this assay as a diagnostic tool in Thailand and suggests a need to reevaluate H. pylori serologic tests when used in populations living in developing countries.

摘要

在发展中国家，检测幽门螺杆菌抗体的血清学方法并不常被用作诊断工具。与一种商用酶联免疫吸附测定（ELISA）相比，在泰国构建并验证的一种ELISA在通过内镜检查评估的104例消化不良患者中检测幽门螺杆菌感染时，具有更高的灵敏度（98%对85%）、特异性（76%对66%）和阴性预测值（97%对76%）。两种检测的阳性预测值均为88%。8名泰国患者在感染根除后5 - 8个月血清抗体水平显著下降（P = 0.009）。到8岁时，生活在泰国城乡的人群中超过50%血清呈阳性。商用ELISA较低的阴性预测值限制了该检测方法在泰国作为诊断工具的实用性，并表明在用于发展中国家人群时需要重新评估幽门螺杆菌血清学检测。