Hodgson M I, Pantoja H, Latorre J J, Vial P, Henríquez A, Wenger J, Peña A, Siri M T, Guiraldes E
Departamento de Pediatría, Pontificia Universidad Católica de Chile, Santiago, Chile.
J Pediatr Gastroenterol Nutr. 1995 Oct;21(3):263-8. doi: 10.1097/00005176-199510000-00003.
A newly developed enzyme-linked immunosorbent assay (ELISA) IgG serological assay for the diagnosis of Helicobacter pylori infection was used recently in two epidemiological surveys in Chile. To evaluate the diagnostic efficacy of this assay in a local symptomatic pediatric population, we studied 70 school-age patients referred for upper gastrointestinal endoscopy because of complaints suggestive of gastroduodenal disease. Evidence for antral H. pylori infection was sought by three biopsy-related methods: culture, histology, and urease activity. IgG anti-H. pylori serum antibodies were determined by ELISA. Altogether, chronic antral gastritis was found in 55 patients and duodenal ulcers in nine; 11 subjects had normal histology. Sixty (86%) patients had H. pylori in the antrum. This group had significantly higher mean IgG optical density values when compared with the H. pylori-negative group (1.860 versus 0.669; p < 0.001). The sensitivity and specificity of the assay in detecting antral H. pylori were both 90%; the positive predictive value was 98% and the negative, 60%. Accuracy of the assay was superior in predicting the presence or absence of gastroduodenal lesions with a sensitivity of 96%, a specificity of 92%, a positive predictive value of 98%, and a negative predictive value of 86%. We conclude that the diagnostic efficiency of this assay renders it appropriate both to screen for H. pylori-associated gastroduodenal disease in individual patients and to be used in seroepidemiological surveys.
一种新开发的用于诊断幽门螺杆菌感染的酶联免疫吸附测定（ELISA）IgG血清学检测方法最近在智利的两项流行病学调查中得到应用。为了评估该检测方法在当地有症状儿童人群中的诊断效能，我们研究了70名因疑似胃十二指肠疾病而转诊进行上消化道内镜检查的学龄患者。通过三种与活检相关的方法来寻找胃窦部幽门螺杆菌感染的证据：培养、组织学检查和尿素酶活性检测。通过ELISA测定抗幽门螺杆菌血清IgG抗体。总共，55例患者发现有慢性胃窦炎，9例有十二指肠溃疡；11名受试者组织学检查正常。60例（86%）患者胃窦部有幽门螺杆菌。与幽门螺杆菌阴性组相比，该组的平均IgG光密度值显著更高（1.860对0.669；p<0.001）。该检测方法检测胃窦部幽门螺杆菌的敏感性和特异性均为90%；阳性预测值为98%，阴性预测值为60%。该检测方法在预测胃十二指肠病变的存在与否方面准确性更高，敏感性为96%，特异性为92%，阳性预测值为98%，阴性预测值为86%。我们得出结论，该检测方法的诊断效率使其既适合于对个体患者筛查幽门螺杆菌相关的胃十二指肠疾病，也适合用于血清流行病学调查。
