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[胃黏膜幽门螺杆菌定植的定性与半定量侵入性及非侵入性诊断]

[Qualitative and semiquantitative invasive and noninvasive diagnosis of Helicobacter pylori colonization of gastric mucosa].

作者信息

Labenz J, Stolte M, Aygen S, Hennemann O, Bertrams J, Börsch G

机构信息

Medizinische Klinik des Elisabeth-Krankenhauses Essen.

出版信息

Z Gastroenterol. 1993 Jul-Aug;31(7-8):437-43.

PMID:8379231
Abstract

In 110 patients with unknown Helicobacter pylori status and without anti-bacterial treatment submitted for routine endoscopy of the upper gastrointestinal tract biopsies were taken from the antral and body mucosa, which were assessed for H. pylori colonisation and/or gastritis by an urease test (Jatrox H. p.-Test), microscopy after methylene-blue staining of a mucosal smear, specific culture and histology (stains: haematoxylin & eosin and Warthin-Starry). In addition, a simplified 13C-urea breath test was validated. A complete set of data was available from 104 patients (64 women - 40 men, median of age: 55 years [range: 17-92 years], H. pylori positive histologically and/or culturally [goldstandard]: n = 67). The test criteria sensitivity, specificity, positive and negative predictive value were calculated to be 100%/100%/100%/100% for the urease test, 76.1%/100%/100%/69.8% for microscopy of a mucosal smear, and 92.5%/97.3%/98.4%/88.1% for 13C-urea breath test (two-point measurement). Statistical analysis demonstrated highly significant (p < 0.0001) correlations between the reaction velocity of the urease test, the histologically visible degree of Helicobacter pylori colonisation and the differences of the delta-values of the 13C-urea breath test on the one hand and between grade and activity of gastritis as well as between the gastritis and activity scores, respectively, and the semi-quantitatively categorized results of the urease test, the histological degree of H. pylori colonisation and the 13C-urea breath test on the other hand.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

110例幽门螺杆菌(Helicobacter pylori,Hp)感染状态不明且未接受过抗菌治疗的患者因上消化道常规内镜检查而就诊,从胃窦和胃体黏膜取活检组织,通过尿素酶试验(Jatrox H.p.试验)、亚甲蓝染色的黏膜涂片显微镜检查、特异性培养及组织学检查(苏木精-伊红染色和Warthin-Starry染色)评估Hp定植情况和/或胃炎情况。此外,还对简化的13C-尿素呼气试验进行了验证。104例患者(64例女性,40例男性,年龄中位数:55岁[范围:17 - 92岁],组织学和/或培养Hp阳性[金标准]:n = 67)获得了完整的数据集。计算得出尿素酶试验的检测标准灵敏度、特异性、阳性预测值和阴性预测值分别为100%/100%/100%/100%,黏膜涂片显微镜检查为76.1%/l00%/100%/69.8%,13C-尿素呼气试验(两点测量)为92.5%/97.3%/98.4%/88.l%。统计分析表明,一方面尿素酶试验的反应速度、组织学可见的Hp定植程度和13C-尿素呼气试验δ值差异之间,另一方面胃炎分级和活动度以及胃炎与活动度评分之间,与尿素酶试验、Hp组织学定植程度和13C-尿素呼气试验的半定量分类结果之间存在高度显著(p < 0.0001)的相关性。(摘要截短于250字)

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