Brown K E, Peura D A
Division of Gastroenterology, University of Virginia Health Sciences Center, Charlottesville.
Gastroenterol Clin North Am. 1993 Mar;22(1):105-15.
In conclusion, H. pylori infection can be detected by a variety of methods. The simplest, least expensive noninvasive method is serologic testing. Unfortunately, positive serology can only presume current infection. Urea breath testing is also noninvasive and is positive only in the setting of current infection; it is more expensive than serology and results in low-level radiation exposure when 14C urea is used. Endoscopy with biopsy is invasive and relatively expensive; however, it is readily available and is frequently performed in the evaluation of the symptomatic individual. In such cases, rapid urease testing of biopsy material is simple and less expensive than histologic examination. Histology allows simultaneous evaluation of tissue injury and infection. Frequently, routine hematoxylin-and-eosin staining is sufficient to permit identification of the bacteria; when the results of this stain are inconclusive, special stains such as Giemsa or Warthin-Starry can be used. Finally, direct culture of the organism from gastric tissue is tedious and expensive; therefore, it should generally be reserved for protocol settings or for selected patients in whom antibiotic-resistant organisms are suspected.
总之，幽门螺杆菌感染可通过多种方法检测。最简单、最便宜的非侵入性方法是血清学检测。不幸的是，血清学阳性仅能推测当前感染情况。尿素呼气试验也是非侵入性的，且仅在当前感染时呈阳性；它比血清学检测更昂贵，使用14C尿素时会导致低水平辐射暴露。内镜检查及活检具有侵入性且相对昂贵；然而，它容易获得，并且在对有症状个体进行评估时经常进行。在这种情况下，对活检材料进行快速尿素酶检测简单且比组织学检查便宜。组织学检查可同时评估组织损伤和感染情况。通常，常规苏木精-伊红染色足以识别细菌；当该染色结果不明确时，可使用特殊染色，如吉姆萨染色或沃辛-斯塔里染色。最后，从胃组织中直接培养该微生物既繁琐又昂贵；因此，它通常应保留用于方案设置或怀疑有抗生素耐药菌的特定患者。
