Delvin E E, Brazier J L, Deslandres C, Alvarez F, Russo P, Seidman E
Clinical Research Center, Sainte-Justine Hospital, Faculty of Medicine, University of Montréal, Québec, Canada.
J Pediatr Gastroenterol Nutr. 1999 Jan;28(1):59-62. doi: 10.1097/00005176-199901000-00014.
The causal association between Helicobacter pylori (H. pylori) colonization of the gastric mucosa and gastritis is now well established. Histologic examination of endoscopic biopsy specimens has long been regarded as the gold standard for diagnosis. However, the changes can be focal in nature and presence of the organism may be missed in nonsampled areas. The urea breath test, which uses a stable isotope, offers distinct advantages, in that it is noninvasive and measures the activity of the micro-organism. It thus represents a potentially invaluable tool in the initial diagnosis of the infection and in verifying its eradication.
The study design was that of a prospective, blinded comparison of the [13C]-urea breath test with histologic assessment of antral biopsy specimens using the Warthin-Starry stain, to diagnose H. pylori infection in a group of 79 consecutive pediatric patients.
Patients classified as negative by histology (n=67) had breath 13C enrichment of 0.97+/-0.07 delta per thousand (mean+/-SEM), with a range of -0.20 and 2.83 delta per thousand. In contrast, those with a positive histologic results (n=12) had an enrichment of 25.41+/-5.01 delta per thousand (range, 3.43-58.80; p < 0.001). At the chosen cutoff point of 3 delta per thousand, the sensitivity and specificity as well as the positive and negative predictive values of the breath test were uniformly 100%.
The [13C]-urea breath test is a highly reliable, noninvasive method for the diagnosis of H. pylori gastritis in children and adolescents.
胃黏膜幽门螺杆菌（H. pylori）定植与胃炎之间的因果关联现已明确确立。长期以来，内镜活检标本的组织学检查一直被视为诊断的金标准。然而，这些变化可能具有局灶性，未采样区域可能会遗漏该微生物的存在。使用稳定同位素的尿素呼气试验具有明显优势，因为它是非侵入性的，并且可以测量微生物的活性。因此，它是感染初始诊断和验证根除情况的潜在宝贵工具。
本研究设计为前瞻性、双盲比较[13C] - 尿素呼气试验与使用Warthin - Starry染色对胃窦活检标本进行组织学评估，以诊断一组79例连续儿科患者的幽门螺杆菌感染。
组织学分类为阴性的患者（n = 67）呼气13C富集为0.97±0.07‰（平均值±标准误），范围为 - 0.20至2.83‰。相比之下，组织学结果为阳性的患者（n = 12）富集为25.41±5.01‰（范围，3.43 - 58.80；p < 0.001）。在选定的3‰截断点时，呼气试验的敏感性、特异性以及阳性和阴性预测值均为100%。
[13C] - 尿素呼气试验是诊断儿童和青少年幽门螺杆菌胃炎的高度可靠、非侵入性方法。
