Felz M W, Burke G J, Schuman B M
Department of Family Practice, Medical College of Georgia, Augusta 30912, USA.
J Am Board Fam Pract. 1997 Nov-Dec;10(6):385-9.
Helicobacter pylori is implicated as the causative agent for most duodenal and gastric ulcers. Invasive (endoscopy and biopsy) and noninvasive (serology, breath test) methods are currently available for definitive diagnosis of infectious peptic ulcer disease.
Twenty-six patients with chronic gastritis symptoms underwent upper endoscopy, biopsy, rapid urease test, and [14C]urea breath test for the detection of H pylori.
Twenty of 26 patients (77 percent) had biopsy-proved H pylori infection. All 20 (100 percent) with definite H pylori proved by invasive diagnosis had strongly positive results on urea breath test. Six patients with absence of H pylori on biopsy had negative urea breath test results. The urea breath test displayed 100 percent sensitivity, specificity, and predictive value compared with endoscopy and biopsy.
[14C]Urea breath testing is comparable to endoscopy and biopsy in the diagnosis of H pylori infection and could become useful in primary care settings for noninvasive evaluation of peptic ulcer disease.
幽门螺杆菌被认为是大多数十二指肠溃疡和胃溃疡的病原体。目前，侵入性（内镜检查和活检）和非侵入性（血清学、呼气试验）方法可用于明确诊断感染性消化性溃疡疾病。
26例有慢性胃炎症状的患者接受了上消化道内镜检查、活检、快速尿素酶试验和[14C]尿素呼气试验以检测幽门螺杆菌。
26例患者中有20例（77%）经活检证实有幽门螺杆菌感染。通过侵入性诊断确诊的所有20例（100%）幽门螺杆菌感染者尿素呼气试验结果均为强阳性。6例活检未发现幽门螺杆菌的患者尿素呼气试验结果为阴性。与内镜检查和活检相比，尿素呼气试验的敏感性、特异性和预测价值均为100%。
[14C]尿素呼气试验在诊断幽门螺杆菌感染方面与内镜检查和活检相当，在基层医疗环境中可用于消化性溃疡疾病的非侵入性评估。
