用于检测幽门螺杆菌感染的改良快速尿素酶试验。

Modified rapid urease test for detection of Helicobacter pylori infection.

作者信息

Malfertheiner P, Enrique Domínguez-Muñoz J, Heckenmüller H, Neubrand M, Fischer H P, Sauerbruch T

机构信息

Department of Internal Medicine, University Hospital of Bonn, Germany.

出版信息

Eur J Gastroenterol Hepatol. 1996 Jan;8(1):53-6. doi: 10.1097/00042737-199601000-00010.

DOI:10.1097/00042737-199601000-00010

PMID:8900909

Abstract

BACKGROUND

The rapid urease test is the most widely used standard procedure for the detection of Helicobacter pylori infection. This is because it is a simple, reliable and inexpensive test, which provides results rapidly.

AIM

The aim of the present study was the evaluation of a modified rapid urease test (HUT-test) in comparison with the standard CLO-test. In addition, it was questioned whether the performance of the rapid urease test in two biopsy samples from antrum and gastric body would increase the sensitivity of the test.

METHODS

One hundred and fifteen consecutive patients undergoing oesophagogastroduodenoscopy were studied. Diagnosis of H. pylori infection was based on histological examination of biopsy samples from antrum and gastric body. The HUT-test was performed in two biopsy specimens from antrum and body, respectively, and the CLO-test in one antral biopsy sample. The time to positivity and the stability of the HUT-test kit at different storage temperatures were previously optimized by adapting the type and concentration of buffer and indicators.

RESULTS

Sixty patients (52%) were diagnosed as being infected with H. pylori. Sensitivity of the rapid urease tests in biopsy samples from the antrum was 90% for the HUT-test and 88% for the CLO-test, with a specificity of 100% for both tests. Combining biopsies from the antrum and corpus increased the diagnostic sensitivity of the HUT-test to 93%, but the specificity decreased to 98%. In patients with H. pylori infection, the HUT-test gave positive results more rapidly than the CLO-test (104 +/- 21 min compared with 195 +/- 49 min, respectively, P < 0.02).

CONCLUSION

Application of the HUT-test to a simple biopsy from the antrum can establish the diagnosis of H. pylori infection with high accuracy, similar to that of the standard CLO-test. Compared with the CLO-test, the HUT-test has a significantly faster reaction time, which is an obvious clinical advantage. An additional biopsy from the distal gastric body did not add to the diagnostic efficacy in untreated patients, but may be needed in specific circumstances, such as following treatment.

摘要

背景

快速尿素酶试验是检测幽门螺杆菌感染最广泛使用的标准方法。这是因为它是一种简单、可靠且廉价的检测方法，能快速得出结果。

目的

本研究的目的是评估改良快速尿素酶试验（HUT试验）并与标准CLO试验进行比较。此外，还探讨了取自胃窦和胃体的两份活检样本进行快速尿素酶试验是否会提高检测的敏感性。

方法

对115例连续接受食管胃十二指肠镜检查的患者进行研究。幽门螺杆菌感染的诊断基于取自胃窦和胃体的活检样本的组织学检查。分别在取自胃窦和胃体的两份活检标本上进行HUT试验，在一份胃窦活检样本上进行CLO试验。通过调整缓冲液和指示剂的类型及浓度，预先优化了HUT试验试剂盒的阳性时间及在不同储存温度下的稳定性。

结果

60例患者（52%）被诊断为幽门螺杆菌感染。胃窦活检样本中快速尿素酶试验的敏感性，HUT试验为90%，CLO试验为88%，两种试验的特异性均为100%。联合胃窦和胃体的活检样本可将HUT试验的诊断敏感性提高到93%，但特异性降至98%。在幽门螺杆菌感染患者中，HUT试验比CLO试验更快得出阳性结果（分别为104±21分钟和195±49分钟，P<0.02）。