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陈维顺 钟燎原 张选均
摘要 目的 评估14C-尿素呼吸试验(14C-UBT)对幽门螺杆菌(HP)感染的诊断价值，并探讨胃粘膜组织学变化对实验结果的影响。方法 取96例因上腹症状行胃镜检查的患者胃窦粘膜活检，分别行改良Giemsa染色和快速尿素酶(RUT)试验，14C-UBT检查；将三项检查中两项(或以上)阳性者定为HP感染，分别对三种方法进行评价，并且观察其在不同胃粘膜病变中HP检出情况。结果 14C-UBT的敏感性、特异性、符合率分别为89.2%，98.3%，94.8%，与组织学方法(改良Giemsa染色为91.9%，93.2%，92.7%，RUT为86.5%，93.2%，90.6%)比较差异无显著性(均P＞0.05)，同时不同胃粘膜病变对14C-UBT结果无明显影响。结论 14C-UBT有较高的敏感性和特异性，是一可靠的非侵入性HP检测方法。
关键词 螺杆菌感染；幽门；病理学；诊断，化验室
A Camparative Study Between 14C-Urea Breath Test and Histologic Examination in the Diagnosis of Helicobacterium Pylori Infection
CHEN Weishun,ZHONG Liaoyuan,ZHANG Xuanjun
The First Municipal Hospital of Zhuzhou,Zhuzhou,421000
Abstract Objective To evaluate the efficiency of 14C-urea breath test(14C-UBT)in the diagnosis of Helicobacterium pylori(HP) infection.Methods 14C-UBT was carried out in 96 patients subjected to gastroscopy owing to their symptomatic attacks of upper abdomen.The results were compared with those of HP histologic examination which included the rapid urease test(RUT)and modified Giemsa staining.Biopsy specimens were obtained from the gastric antrum by endoscopy. Results The sensitivity,specificity and accuracy of 14C-UBT were 89.2%,98.3% and 94.8%,respectively.There were no significant differences as compared with those of histologic examination(RUT:86.5%,93.2% and 90.6%;Giemsa staining:91.9%,93.2% and 92.7%)(P＞0.05).Moreover,These parameters of 14C-UBT were not affected by the pathologic changes in gastric mucosa.Conclusion These data showed that
14C-UBT is a reliable non-invasive test and has an excellent sensitivity and specificity for the detection of HP infection.
Key words helicobacter infections;pylorus;pathology;diagnosis,laboratory
幽门螺杆菌(HP)感染是慢性胃炎和消化性溃疡的主要病因，也是胃肿瘤发生的高危因素［1］，故正确诊断HP并给予积极治疗是胃十二指肠疾病防治的重要环节。目前诊断HP的方法可分为侵入性和非侵入性两类，前者从内镜下取胃粘膜活检，行HP培养、组织学染色及尿素酶试验。后者包括13C或14C-尿素呼吸试验(14C-UBT)、血清抗HP抗体检测等，其中14C-UBT是国内刚开展的HP检测项目。本文旨在进一步验证该方法对H[1] [2] 下一页
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